Heart rate variables in the Vascular Quality Initiative are not reliable predictors of adverse cardiac outcomes or mortality after major elective vascular surgery

Objective Heart rate (HR) parameters are known indicators of cardiovascular complications after cardiac surgery, but there is little evidence of their role in predicting outcome after major vascular surgery. The purpose of this study was to determine whether arrival HR (AHR) and highest intraoperati...

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Bibliographic Details
Published in:Journal of vascular surgery 2015-09, Vol.62 (3), p.710-720.e9
Main Authors: Scali, Salvatore, MD, Bertges, Daniel, MD, Neal, Daniel, MS, Patel, Virendra, MD, MPH, Eldrup-Jorgensen, Jens, MD, Cronenwett, Jack, MD, Beck, Adam, MD
Format: Article
Language:English
Subjects:
Adrenergic beta-Antagonists - therapeutic use
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal - diagnosis
Aortic Aneurysm, Abdominal - mortality
Aortic Aneurysm, Abdominal - physiopathology
Aortic Aneurysm, Abdominal - surgery
Elective Surgical Procedures
Female
Heart Diseases - diagnosis
Heart Diseases - etiology
Heart Diseases - mortality
Heart Rate - drug effects
Humans
Male
Middle Aged
Monitoring, Intraoperative
Peripheral Arterial Disease - diagnosis
Peripheral Arterial Disease - mortality
Peripheral Arterial Disease - physiopathology
Peripheral Arterial Disease - surgery
Predictive Value of Tests
Quality Indicators, Health Care - standards
Registries
Risk Assessment
Risk Factors
Surgery
Time Factors
Treatment Outcome
United States - epidemiology
Vascular Surgical Procedures - adverse effects
Vascular Surgical Procedures - mortality
Vascular Surgical Procedures - standards
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Summary:Objective Heart rate (HR) parameters are known indicators of cardiovascular complications after cardiac surgery, but there is little evidence of their role in predicting outcome after major vascular surgery. The purpose of this study was to determine whether arrival HR (AHR) and highest intraoperative HR are associated with mortality or major adverse cardiac events (MACEs) after elective vascular surgery in the Vascular Quality Initiative (VQI). Methods Patients undergoing elective lower extremity bypass (LEB), aortofemoral bypass (AFB), and open abdominal aortic aneurysm (AAA) repair in the VQI were analyzed. MACE was defined as any postoperative myocardial infarction, dysrhythmia, or congestive heart failure. Controlled HR was defined as AHR 
ISSN:0741-5214
1097-6809
DOI:10.1016/j.jvs.2015.03.071