Results of a survey of anesthesiologists and resuscitation specialists: possible prediction and diagnosis of cardiac complications after non-cardiac surgery

Relevance. A critical task of modern anesthesiology and resuscitation is the prediction and diagnosis of cardiac complications after non-cardiac surgeries. There are clinical guidelines for reducing the incidence of such complications; however, in practice, routine implementation of the full-risk stratification algorithm is not always performed. Objective. To assess the possibility of predicting and diagnosing cardiac complications after non-cardiac surgeries in medical organizations of constituent entities of the Russian Federation with a population of less than 1 million people. Materials and methods. An anonymous online survey of anesthesiologists and resuscitators of one of the constituent entities of the Russian Federation was developed using Yandex Forms.

Results. We processed 62 completed questionnaires. Cardiac complications during the postoperative period are registered by 33 (53.2 %) respondents. Cardiac risk indices were used by 10 (16.1 %) physicians and load tests (treadmill, bicycle ergometry) by 9 (14.5 %). Routine ECG monitoring after surgery was performed by 27 (43.5 %) respondents. Cardiac-specific troponin determination is available to 60 (96.8 %) physicians; however, only 6 (9.7 %) respondents measured it routinely before surgery and 4 (6.5 %) respondents measured it after surgery. Natriuretic peptide or its prohormone determination is available to 19 (30.6 %) physicians; however, only 3 (4.8 %) prescribe it before surgery and 0 after surgery. The possibility of performing echocardiography before and after surgery was noted by 54 (87.1 %) respondents. Only 9 (14.5 %) respondents reported that their hospital could perform coronary angiography.

Conclusions. The results of this survey revealed that many cardiac complications could have been missed because of insufficient preoperative prognosis and postoperative diagnostic data.

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