Can postoperative st-segment change and blood pressure variability predict short-term mortality in patients following major vascular surgery?

Abstract

© JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND | 2019. Objective: To evaluate the association between the ST-segment abnormality, blood pressure variability (BPV), and short-term mortality in patients who had undergone major vascular surgery. Materials and Methods: A prospective cohort study of 71 patients that underwent major vascular surgery between June 2011 and May 2013 at Maharaj Nakorn Chiang Mai Hospital was completed. Blood pressure was recorded for the first week after surgery, as well as electrocardiograms at baseline and for the first four post-operative days. The association between abnormality of ST-segment, BPV, and short-term mortality were analyzed. Results: Nine (13%) patients had ST-segment change and 18 (25%) patients had BPV in the first week of post-operation. The median follow-up was 11 months. Thirteen (18%) patients died during follow-up. Post-operative ST-change was associated with a significantly increased risk of short-term mortality (hazard ratio (HR) 24.74, 95% confidence interval (CI) 6.23 to 98.27). BPV was also associated with short-term mortality (HR 4.65, 95% CI 1.31 to 16.49). In addition, the risk of stroke in patients with BPV was 20.6 times higher than those without BPV. Conclusion: ST-change and BPV after major vascular surgery were associated with a significantly increased risk of short-term mortality.