Preoperative Diastolic Dysfunction and Postoperative Outcomes after Noncardiac Surgery

Area of Science:

• Cardiology
• Anesthesiology
• Nephrology

Background:

• Diastolic dysfunction is a common finding in patients undergoing surgery.
• Its independent association with adverse perioperative outcomes remains unclear.

Purpose of the Study:

• To investigate the independent association of diastolic dysfunction with in-hospital mortality, acute kidney injury, and hospital length of stay after noncardiac surgery.

Main Methods:

• Retrospective observational cohort study at an academic referral center.
• Included patients undergoing noncardiac surgery with pre-operative transthoracic echocardiograms.
• Diastolic dysfunction graded using 2016 American Society of Echocardiography guidelines.

Main Results:

• 23% of 7,312 patients had diastolic dysfunction, often associated with older age and more comorbidities.
• No significant association was found between diastolic dysfunction and increased in-hospital mortality (2.3% overall).
• Diastolic dysfunction was not significantly associated with acute kidney injury or prolonged hospital length of stay after adjustment for confounders.

Conclusions:

• Diastolic dysfunction does not appear to independently increase in-hospital mortality, acute kidney injury, or hospital length of stay in noncardiac surgical patients.
• Findings highlight potential limitations in current perioperative risk stratification.
• Further research may be needed to refine risk prediction models for surgical patients with diastolic dysfunction.