• Mark Willingham, Samir Al- Ayoubi, Michael Doan, Theodora Wingert, Jennifer Scovotti, Kim Howard-Quijano, and Jacques Prince Neelankavil.
• Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles, Los Angeles, CA. Presently affiliated with the Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO. Electronic address: Mdw3@wustl.edu.
• J. Cardiothorac. Vasc. Anesth. 2020 Mar 1; 34 (3): 679-686.

ObjectiveTo determine if diastolic dysfunction is independently associated with increased mortality, acute kidney injury, and hospital length of stay after noncardiac surgery.DesignRetrospective observational cohort.SettingAcademic referral center.ParticipantsAll patients undergoing noncardiac and nonliver-transplant surgeries at University of California - Los Angeles between April 2013 and October 2017, who also had transthoracic echocardiograms performed within 6 months preceding their procedures.InterventionsNone.Measurements And Main ResultsPatients' demographic, comorbidity, echocardiographic, and perioperative data were queried from the electronic health record. Diastolic dysfunction was graded by automated application of 2016 American Society of Echocardiography guidelines to queried echocardiographic measurements. During the study period, 12,871 eligible records were identified, of which 7,312 represented unique procedures with complete information. Twenty-three percent of patients had echocardiographic evidence of diastolic dysfunction (7.0% grade 1, 8.1% grade 2, 0.6% grade 3, and 7.5% nonspecific). Patients with diastolic dysfunction tended to be older and have higher American Society of Anesthesiologists scores with more comorbidities. Overall, 166 patients (2.3%) experienced an in-hospital death. After adjustment for potentially confounding variables, diastolic dysfunction was not significantly associated with increased in-hospital mortality, acute kidney injury, or hospital length of stay.ConclusionsDiastolic dysfunction does not appear to be associated with increased in-hospital mortality, acute kidney injury, or hospital length of stay in a cohort of noncardiac surgical patients at an academic medical center. These results highlight uncertainties in perioperative risk determination.Copyright © 2019 Elsevier Inc. All rights reserved.

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