Surprise Surgery Cost Saving Lives

Surgery can save lives from cardiovascular complications, major blood clots in the legs and lungs and amputations. A new study by a Cleveland Clinic cardiologist and surgeon found men who had emergency appendectomies had 83 percent lower cardiac risk factors versus those who didn’t. The findings may set the standard for cardiac surgeons to treat these patients.

The research team studied patient data gathered from 132 patients who underwent appendectomies in Cleveland Clinic hospitals between 2010 and 2018. They also included patients with serious, non-cardiac conditions thought to be inconsequential, as these patients were referred for doctor-diagnosed conditions.

The analysis focused on four known cardiac risk factors: stable angina, heart muscle function, angina, stent angioedema or anterior descending artery obstruction, and aortic aneurysm.

Predicting cardiac eventsIn their study, the research team evaluated the risk factors for serious, non-cardiac conditions in the weeks leading up to surgery for appendectomies, then calculated the total number of events. Deaths from cardiovascular, other complications and cancer were excluded.

Cardiac events included: chest pain; chest multiple myeloma (a tumor in the cardiac muscles); heart attack; fast heart failure; stroke; or heart failure with intracardiac stenting (interfixed tubing used around the heart).

The surgery was performed 3.7 months after the procedure, while only 2.2 months before the heart failure.

A cardiac surgery team would do a similar assessment again 2 months later, up to three months after the early procedures. Cardiac outcomes would be reassessed 3.7 months after surgery.

Cardiovascular events included: pulmonary embolism; sinus pain; abdominal aortic aneurysm; and small, small anterior descending artery obstruction or partial hernia.

That amount of time also allowed the researchers to assess the effects of the surgery on other outcomes. In the case of the obstructive quality of life outcomes, the researchers found patients would have seen a 13 percent decrease in the number of urgent medical procedures for heart failure compared with those who didn’t have the procedure. Then, after adjusting for other cardiac risk factors, the value of surgery fell to 9 percent.

A cardiologist could use year-round flow-type arterial pressure monitors, so the information would become long-term, the study said.

Whatever the cost or recovery period, patients and surgeons can make sure patients have the best possible outcomes and could discuss the options, Yuranty said.

The study is published in JAMA Surgery.