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Perioperative outcomes of hypertrophic cardiomyopathy: An insight from the National Readmission Database

Kirolos Barssoum1, Abdelrhman Abumoawad2, Medhat Chowdhury3

  • 1University of Texas Medical Branch, Galveston, TX, United States of America.

International Journal of Cardiology
|November 18, 2023
PubMed

Insights

Patients with hypertrophic obstructive cardiomyopathy (HOCM) face higher risks of in-hospital death and readmission after noncardiac surgery. Acute heart failure and cardiac arrhythmias are common complications, necessitating further research for this population.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Anesthesiology

Background:

  • Limited data exists on perioperative outcomes for patients with hypertrophic obstructive cardiomyopathy (HOCM) undergoing noncardiac surgery.
  • This study addresses the lack of information by examining outcomes in this specific patient group.

Purpose of the Study:

  • To investigate the in-hospital and 90-day readmission outcomes for patients with HOCM undergoing noncardiac surgery.
  • To identify specific complications and risks associated with noncardiac procedures in HOCM patients.

Main Methods:

  • Utilized the National Readmission Database (2016-2019) to identify HOCM patients undergoing noncardiac surgery.
  • Analyzed hospital outcomes and 90-day readmission data, adjusting for major clinical predictors.
  • Compared outcomes between HOCM patients and a matched cohort of non-HOCM patients.

Main Results:

  • Identified 16,098 HOCM patients and over 21 million non-HOCM patients.
  • HOCM patients exhibited higher rates of in-hospital death (OR 1.33), acute myocardial infarction (OR 1.18), acute heart failure (OR 1.30), and cardiogenic shock (OR 2.09).
  • Increased 90-day readmission rates (OR 1.237) were observed in HOCM patients, with cardiac arrhythmias (especially atrial fibrillation) being the most common cause for readmission.

Conclusions:

  • HOCM patients undergoing noncardiac surgery are at a significantly increased risk for adverse in-hospital and readmission events.
  • Acute heart failure was the primary complication during the initial hospital stay, whereas cardiac arrhythmias predominated during readmissions.
  • Further research and tailored management strategies are crucial for this vulnerable patient population.
Abstract

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