What’s the Claim?
Perhaps the greatest imperative we face when recommending surgery is ensuring that the patient survives. An enormous registry study helps us do that. It found:
- The 30-day risk of death following surgery among patients with a prior cardiovascular event — acute coronary syndrome (ACS) or stroke — was elevated if elective surgery was performed within 14 months of the cardiovascular event.
- For major procedures where there’s otherwise a low risk of death (like hip arthroplasty), an elevated risk of death was observed if surgery was performed within 18 months of ACS or stroke.
- Risk decreases steeply over time, but the adjusted odds of death after orthopaedic surgery remained nearly double even 12 months after a cardiovascular event.
Although this is observational research, these findings are both practical and important — about 10% of patients who had surgery within a year of a cardiovascular event died within 30 days of that surgical procedure, so these findings deserve our attention.