Risk Factors Of Perioperative Cardiovascular Events In Diabetic Patients Undergoing Noncardiac Surgery: An Analysis

Objective: To study risk factors of perioperative cardiovascular events (PCE) in diabetic patients undergoing noncardiac surgery.Methods: 395 Patients with cardiac risk underwent noncardiac procedure during period from March 2007 to March 2008 were divided into two group according to the patients with or without mellitus diabetes. The ASA score , physical fitness assessment , accompanied disease, anesthetic procedure and surgery course were documented in all patients. Holter monitoring were kept until 48h after surgery. Clinical records of all patients were reviewed.Result: Mellitus diabetes, ST-segment change before surgery, blood loss in operation and unstable hemodynamics in surgery are independent risk factors of PCE. Compared with the group without diabetes the group with diabetes had more cardiovascular events (30.9% vs 20.7%, P<0.05). Coronary disease, ST-segment change before surgery, exercise tolerance grade, preoperative triglyceride levels and unstable hemodynamics in surgery are independent risk factors of PCE in diabetic patients and gender, age, diagnosed recently diabetes, insulin therapy, organ damage were not. The PCE of diabetic patients were atrium fibrillation (6.36%), ventricular arrhythmias (10.91%), cardiac ischemia (16.36%).Conclusion: Diabetes is the independed risk factors of PCE. Coronary heart disease, ST-segment change before surgery, exercise tolerance grade, preoperative triglyceride levels and unstable hemodynamics in surgery are independent risk factors of PCE in diabetic patients. The PCE of diabetic patients were atrium fibrillation, ventricular arrhythmias and cardiac ischemia.