Avaliação prospectiva dos fatores de risco para complicações cardiovasculares em cirurgias extracardíacas
Arquivos
Data
1997
Autores
Ferreira, Silvia Menezes 
Orientadores
Carvalho, Antonio Carlos
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
A presente investigacao teve o proposito de estudar as diversas variaveis a serem classificadas como fatores de risco para complicacoes cardiovasculares em pacientes internados para cirurgias extracardiacas. Os dados basicos foram extraidos da avaliacao de 1.162 pacientes, com doencas de tratamento cirurgico eletivo, sob anestesia geral, peridural ou raquianestesia e com acompanhamento diario pelos pesquisadores envolvidos com o trabalho, no decorrer de todo periodo pos-operatorio. Este conjunto de pacientes compreendia: 573 (49,3%) homens e 589 (50,7%) mulheres, com idades variando entre 11 e 95 anos. As variaveis estudadas consideradas mais relevantes durante a avaliacao foram: cirurgia de grande porte; presenca de doenca degenerativa neoplasica e perda ponderal importante com padrao de desnutricao; sintomas cardiovasculares isolados; idade maior ou igual a 60 anos; presenca de antecedentes de hipertensao arterial sistemica, diabetes melito e consumo tabagistico; cirurgia periferica; pneumopatia pregressa e atual; cardiopatia pregressa e atual; tempo de cirurgia maior ou igual a quatro horas e meia; presenca de complicacoes cardiovasculares; extra-sistoles ventriculares polimorficas e frequentes; terceira bulha e ou estase jugular; fibrilacao atrial e o tempo decorrido do ultimo episodio de infarto do miocardio, ou seja de tres a seis meses antes do ato cirurgico. Os fatores que exerceram influencia no surgimento, para complicacoes cardiovasculares nas cirurgias de grande porte foram: idade maior ou igual a 60 anos, tempo cirurgico maior ou igual a quatro horas e meia e a presenca de extra-sistoles ventriculares polimorficas e frequentes. Ja os principais fatores condicionadores para complicacoes cardiovasculares nas cirurgias perifericas foram: infarto do miocardio de tres a seis meses, tempo cirurgico maior ou igual a quatro horas e meia e a presenca de extra-sistoles ventriculares polimorficas e frequentes
The present investigation had the purpose of studying the different variables to be classified as risk factors for cardiovascular complication in noncardiological surgery during the hospital stay. The basic data were taken from the evaluation of 1162 patients with diseases of elective surgical treatment with general, epidural or spinal anesthesia. The sample was composed of 573 (49,3%) men and 589 (50,7%) women within the range of 11-95 years of age. We kept a daily follow-up of all patients during the post-surgery period. The most important variables studied during the evaluation were: major surgery; degenerative disease with important weight loss and malnutrition pattern; isolated cardiovascular symptoms; age equal or greater than 60 years; history of systemic arterial hypertension, diabetes mellitus and tabacco addiction; peripheral surgery; past and current pneumophathy with symptoms; past and current cardiophathy with symptoms; period of surgery equal or greater than four and a half hours; cardiovascular complications; frequent and polimorphic ventricular extrasystoles; third roof and or jugular stasys; atrial fibrilation; and a period of at of at least three and at most six months between the last myocardial infarct and the surgery. The influencing factors for cardiovascular complications in major surgeries were: age equal or greater than 60 years, period of surgery equal or greater than four hours and a half, presence of frequent and polimorphic ventricular extrasystoles. The main conditioning factors of cardiovascular complications in peripheral surgies were: myocardial infarct, period of surgery equal or greater than four hours and a half and the presence of frequent and polimorphic ventricular extrasystoles.
The present investigation had the purpose of studying the different variables to be classified as risk factors for cardiovascular complication in noncardiological surgery during the hospital stay. The basic data were taken from the evaluation of 1162 patients with diseases of elective surgical treatment with general, epidural or spinal anesthesia. The sample was composed of 573 (49,3%) men and 589 (50,7%) women within the range of 11-95 years of age. We kept a daily follow-up of all patients during the post-surgery period. The most important variables studied during the evaluation were: major surgery; degenerative disease with important weight loss and malnutrition pattern; isolated cardiovascular symptoms; age equal or greater than 60 years; history of systemic arterial hypertension, diabetes mellitus and tabacco addiction; peripheral surgery; past and current pneumophathy with symptoms; past and current cardiophathy with symptoms; period of surgery equal or greater than four and a half hours; cardiovascular complications; frequent and polimorphic ventricular extrasystoles; third roof and or jugular stasys; atrial fibrilation; and a period of at of at least three and at most six months between the last myocardial infarct and the surgery. The influencing factors for cardiovascular complications in major surgeries were: age equal or greater than 60 years, period of surgery equal or greater than four hours and a half, presence of frequent and polimorphic ventricular extrasystoles. The main conditioning factors of cardiovascular complications in peripheral surgies were: myocardial infarct, period of surgery equal or greater than four hours and a half and the presence of frequent and polimorphic ventricular extrasystoles.
Descrição
Citação
Ferreira, Silvia Menezes. Avaliação prospectiva dos fatores de risco para complicações cardiovasculares em cirurgias extracardíacas. 129 f. 1997. Tese (Doutorado em Ciências) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 1997.