A retrospective cohort: Impact the influence of smoking in cardiovascular events (acute myocardial infarction; acute lung edema, hemodynamic instability arrhythmia and cardiac death) of perioperative in noncardiac surgeries / Estudo de coorte retrospectivo: impacto do tabagismo nos eventos cardiovasculares (infarto agudo do miocárdio; edema agudo de pulmão, arritmia com instabilidade hemodinâmica e morte cardíaca) no perioperatório de operações não cardíacas

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

I NTRODUCTION: Despite the importance of smoking in the process cardiovascular disease in modern society, the assessments of cardiac risk preoperative haven´t demonstrated an association between smoking (as independent variable) and postoperative cardiac events. Generally, in the researches, indicate as independent variables : myocardial infarction, chronic renal failure, diabetes, angina, age, etc. OBJECTIVE: To assess the impact of smoking in postoperative cardiac complications of non-cardiac surgery. METHODS: A retrospective cohort study designed at General Hospital with 1072 patients. The patients were divided into Current Smokers (n = 265), Past Smokers (n = 335) and Nonsmokers (n = 462). The three groups were analyzed for combined cardiovascular outcomes in postoperative (infarction, pulmonary edema; arrhythmia with hemodynamic instability, unstable angina, cardiac death) and 30-days mortality. The chi-square test and logistic regression were used, considering p<0.05 as significant. RESULTS: The combined cardiovascular outcomes in postoperative and 30-days mortality were 71 (6.6%) and 34 (3.2%), respectively. The Current and Past Smokers presented 53 (8.8%) combined cardiac events than Nonsmokers which showed 18 (3.8%), p = 0002. The 30-days mortality, Current and Past Smokers presented 26 (4.3%) while Nonsmokers 8 (1.7%), p= 0024. At multivariate analysis, age, emergency operation, cardiac failure, left ventricular hypertrophy, coronary-artery revascularization and ventricular premature contractions were independent variables associated with postoperative cardiac events. Another hand, age, emergency operation, cardiac failure, left ventricular hypertrophy, operation of cancer, liver failure, and abnormality laboratories tests were independent variables associated with 30-days mortality after surgery. CONCLUSION: There are more cardiac events and high mortality with Current and Past smokers when compared to nonsmokers. Many independent variables were associated with cardiac postoperative cardiac events and 30-days mortality. However, Current Smoking was unique modifiable variable find out.

ASSUNTO(S)

smoking cuidados pré-operatórios preoperative care tabagismo assistência perioperatório complicações intra-operatórios per operative assistence intraoperative complications complicações pós-operatórias postoperative complications

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