Clinical and Pathological Analysis of Sudden Death after Planned Surgery
Introduction. The growth of oncological morbidity and the advent of novel surgery methods to improve quality of life and longevity entail a steady growth of noncardiac surgery in elderly patients. Provided the general aging of the population, an increase in the number of comorbid patients and a grow...
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| Format: | Article |
| Language: | English |
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Bashkir State Medical University
2020-07-01
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| Series: | Креативная хирургия и онкология |
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| Online Access: | https://www.surgonco.ru/jour/article/view/494 |
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| author | A. V. Samorodov A. L. Urakov K. N. Zolotukhin R. R. Dashkin N. G. Ismagilov A. I. Abubakirova Z. R. Pakhomova Z. R. Mukhametshina |
| author_facet | A. V. Samorodov A. L. Urakov K. N. Zolotukhin R. R. Dashkin N. G. Ismagilov A. I. Abubakirova Z. R. Pakhomova Z. R. Mukhametshina |
| author_sort | A. V. Samorodov |
| collection | DOAJ |
| description | Introduction. The growth of oncological morbidity and the advent of novel surgery methods to improve quality of life and longevity entail a steady growth of noncardiac surgery in elderly patients. Provided the general aging of the population, an increase in the number of comorbid patients and a growing use of medical implanted devices, the assessment of main risk factors for perioperative complications acquires a higher relevance.Materials and methods. On the basis of a clinical case of an elderly patient, approaches to perioperative risk assessment; methods for risk factor isolation during the preoperative stage; and the importance of informing the patient about the incurred risk are discussed.Results and discussion. A postmortem examination established stage IV coronary atherosclerosis of 3rd degree, stenosis of left and right coronary artery lumen to 60–80%, atherosclerotic plaque wall raptures in the left coronary artery with haemorrhage into the base (“unstable plaque”), ischemic myocardial dystrophy, pockets of abnormal myocardial blood flow. Th e conducted analysis of the clinical case, along with a review of existing literature sources and American and European guidelines for cardiac risk assessment in non-surgical patients, demonstrates the need for updating domestic recommendations on perioperative risk assessment. Such a revision should complement the current international experience with the meta-analysis of the prognostic value of stress tests, routine coronary angiography and preventive pre-surgical coronary recanalisation.Conclusion. It can be concluded that the existing clinical recommendations and risk assessment scales fail to provide immediate solutions to ensure sufficient patient’s safety in the operating room; rather, these documents should only be considered as a vector for decision making in particular clinical circumstances. |
| format | Article |
| id | doaj-art-add49a135f7a4fc394279bfefaaf5ffd |
| institution | DOAJ |
| issn | 2076-3093 2307-0501 |
| language | English |
| publishDate | 2020-07-01 |
| publisher | Bashkir State Medical University |
| record_format | Article |
| series | Креативная хирургия и онкология |
| spelling | doaj-art-add49a135f7a4fc394279bfefaaf5ffd2025-08-20T02:53:29ZengBashkir State Medical UniversityКреативная хирургия и онкология2076-30932307-05012020-07-0110215416110.24060/2076-3093-2020-10-2-154-161382Clinical and Pathological Analysis of Sudden Death after Planned SurgeryA. V. Samorodov0A. L. Urakov1K. N. Zolotukhin2R. R. Dashkin3N. G. Ismagilov4A. I. Abubakirova5Z. R. Pakhomova6Z. R. Mukhametshina7Bashkir State Medical UniversityIzhevsk State Medical AcademyG.G. Kuvatov Republican Clinical HospitalG.G. Kuvatov Republican Clinical HospitalG.G. Kuvatov Republican Clinical HospitalG.G. Kuvatov Republican Clinical HospitalG.G. Kuvatov Republican Clinical HospitalG.G. Kuvatov Republican Clinical HospitalIntroduction. The growth of oncological morbidity and the advent of novel surgery methods to improve quality of life and longevity entail a steady growth of noncardiac surgery in elderly patients. Provided the general aging of the population, an increase in the number of comorbid patients and a growing use of medical implanted devices, the assessment of main risk factors for perioperative complications acquires a higher relevance.Materials and methods. On the basis of a clinical case of an elderly patient, approaches to perioperative risk assessment; methods for risk factor isolation during the preoperative stage; and the importance of informing the patient about the incurred risk are discussed.Results and discussion. A postmortem examination established stage IV coronary atherosclerosis of 3rd degree, stenosis of left and right coronary artery lumen to 60–80%, atherosclerotic plaque wall raptures in the left coronary artery with haemorrhage into the base (“unstable plaque”), ischemic myocardial dystrophy, pockets of abnormal myocardial blood flow. Th e conducted analysis of the clinical case, along with a review of existing literature sources and American and European guidelines for cardiac risk assessment in non-surgical patients, demonstrates the need for updating domestic recommendations on perioperative risk assessment. Such a revision should complement the current international experience with the meta-analysis of the prognostic value of stress tests, routine coronary angiography and preventive pre-surgical coronary recanalisation.Conclusion. It can be concluded that the existing clinical recommendations and risk assessment scales fail to provide immediate solutions to ensure sufficient patient’s safety in the operating room; rather, these documents should only be considered as a vector for decision making in particular clinical circumstances.https://www.surgonco.ru/jour/article/view/494elderly patientssurgical treatmentperioperative periodsudden deathrisk factorsmyocardial infarctionintraoperative complications |
| spellingShingle | A. V. Samorodov A. L. Urakov K. N. Zolotukhin R. R. Dashkin N. G. Ismagilov A. I. Abubakirova Z. R. Pakhomova Z. R. Mukhametshina Clinical and Pathological Analysis of Sudden Death after Planned Surgery Креативная хирургия и онкология elderly patients surgical treatment perioperative period sudden death risk factors myocardial infarction intraoperative complications |
| title | Clinical and Pathological Analysis of Sudden Death after Planned Surgery |
| title_full | Clinical and Pathological Analysis of Sudden Death after Planned Surgery |
| title_fullStr | Clinical and Pathological Analysis of Sudden Death after Planned Surgery |
| title_full_unstemmed | Clinical and Pathological Analysis of Sudden Death after Planned Surgery |
| title_short | Clinical and Pathological Analysis of Sudden Death after Planned Surgery |
| title_sort | clinical and pathological analysis of sudden death after planned surgery |
| topic | elderly patients surgical treatment perioperative period sudden death risk factors myocardial infarction intraoperative complications |
| url | https://www.surgonco.ru/jour/article/view/494 |
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