Outcomes of noncardiac, nonobstetric surgery in patients with PAH: An international prospective survey

Stephanie Meyer, Vallerie V. McLaughlin, Hans Juergen Seyfarth, Todd M. Bull, Carmine D. Vizza, Mardi Gomberg-Maitlande, Ioana R. Preston, Joan A. Barberà, Paul M. Hassoun, Michael Halank, Xavier Jaïs, Nils Nickel, Marius M. Hoeper, Marc Humbert

Research output: Contribution to journalArticle

Abstract

We conducted an international, prospective, 3-year questionnaire-based survey among 11 pulmonary hypertension centres to assemble data from patients with pulmonary arterial hypertension (PAH) undergoing noncardiac and nonobstetric surgery. Data were collected between July 2007 and June 2010 from 114 patients with PAH (70% female, mean age 57 years) who underwent major surgery. At the time of surgery, 43% were in functional class III/IV. 82% of the interventions were performed under general anaesthesia and 18% under spinal anaesthesia. Major complications occurred in seven (6.1%) of the patients, of whom four died, resulting in an overall perioperative mortality rate of 3.5%. The mortality rate was 15% (two out of 13) in emergency procedures, compared with 2% (two out of 101) in nonemergency procedures (p=0.01). Risk factors for major complications were an elevated right atrial pressure (OR 1.1, 95% CI 1.0-1.3; p=0.01), a 6-min walking distance <399 m at the last preoperative assessment (OR 2.2, 95% CI 1.1-3.7; p=0.04), the perioperative use of vasopressors (OR 1.5, 95% CI 1.2-2.7; p=0.03) and the need for emergency surgery (OR 2.4, 95% CI 1.4-3.6; p=0.01). Major surgery in patients with PAH continues to be a high-risk procedure, particularly when emergency interventions are needed. Copyright

Original languageEnglish (US)
Pages (from-to)1302-1307
Number of pages6
JournalEuropean Respiratory Journal
Volume41
Issue number6
DOIs
StatePublished - Jun 1 2013

Keywords

  • Anaesthesia
  • Hypertension
  • Pulmonary
  • Surgery
  • Survival

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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    Meyer, S., McLaughlin, V. V., Seyfarth, H. J., Bull, T. M., Vizza, C. D., Gomberg-Maitlande, M., Preston, I. R., Barberà, J. A., Hassoun, P. M., Halank, M., Jaïs, X., Nickel, N., Hoeper, M. M., & Humbert, M. (2013). Outcomes of noncardiac, nonobstetric surgery in patients with PAH: An international prospective survey. European Respiratory Journal, 41(6), 1302-1307. https://doi.org/10.1183/09031936.00089212