• J Clin Anesth · Feb 2017

    Impact of ejection fraction on infectious, renal, and respiratory morbidity for patients undergoing noncardiac surgery.

    • Michael D Maile, William F Armstrong, Elizabeth S Jewell, and Milo C Engoren.
    • Department of Anesthesiology, University of Michigan, 1500 Medical Center Dr, Ann Arbor, MI, USA. Electronic address: mmaile@med.umich.edu.
    • J Clin Anesth. 2017 Feb 1; 36: 1-9.

    ObjectiveWe sought to determine if decreased left ventricular systolic function was associated with an increased risk of postoperative infectious, respiratory, or renal complications in patients undergoing noncardiac surgery.DesignRetrospective cohort study.SettingSingle tertiary-care, university-based medical center.PatientsWe studied individuals who participated in the American College of Surgeons National Quality Improvement Program and had a preoperative echocardiogram conducted at our institution.InterventionsNone.MeasurementsThe incidences of postoperative respiratory (need for postoperative mechanical ventilation or unplanned intubation), renal (acute renal failure or renal insufficiency), and infectious (pneumonia, urinary tract infection, sepsis, or wound infection) complications were analyzed.Main ResultsPostoperative infections (n=175, 10%) represented the most common postoperative complication seen in the study population of 1692 individuals. Respiratory complications occurred in 77 (5%) and renal complications occurred in 29 (2%) participants. The time between the echocardiogram and surgery ranged from 7 months (interquartile range [IQR] 1.8-15.7) for those with severely reduced left ventricular ejection fraction (LVEF) to 24 months (IQR 2.5-38.6) for those with a normal LVEF (P=.038). Univariate analysis demonstrated a relationship between decreased preoperative LVEF and infectious and renal complications, but not respiratory complications. After adjusting for preoperative characteristics, decreased preoperative LVEF was associated with infectious (odds ratio, 1.33; 95% confidence interval, 1.03-1.68; P=.0265) and renal (odds ratio, 1.69; 95% confidence interval, 1.12-2.48; P=.0142) complications.ConclusionsDecreased preoperative LVEF is associated with postoperative infections and renal complications.Copyright © 2016 Elsevier Inc. All rights reserved.

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