Incidence and predictors of 30-day cardiovascular complications in patients undergoing head and neck cancer surgery

Abstract

<p>Incidence and predictors of peri-operative or post-operative cardiovascular complications in head and neck cancer surgery remain poorly elucidated. In this retrospective study, we investigated the rate and pre-operative risk factors for cardiovascular and cerebrovascular complications. This study included all patients (<em>n</em> = 456) operated for head and neck cancer between 1999 and 2008. Patients’ medical records were reviewed and the adjudication of endpoints was performed by adjudication committee. The 30-day incidence of cardiovascular and cerebrovascular complications was 7.2 %. Cardiac mortality at 30 days was 1.0 %. Univariate predictors of MACCE (major adverse cardiac and cerebrovascular events) at the 30-day follow-up were history of myocardial infarction (OR 4.56, 95 % CI 1.73–11.97, <em>p</em> = 0.002); history of heart failure (OR 4.14, 95 % CI 1.32–13.02, <em>p</em> = 0.015); pre-existing coronary artery disease (OR 3.98, 95 % CI 1.75–9.06, <em>p</em> = 0.001); prior aspirin medication (OR 3.73, 95 % CI 1.81–7.71, <em>p</em> < 0.001); prior betablocker medication (OR 3.67, 95 % CI 1.79–7.51, <em>p</em> < 0.001); hypertension (OR 2.55, 95 % CI 1.25–5.19, <em>p</em> = 0.010); and increasing age (OR 1.08, 95 % CI 1.05<em>–</em>1.12, <em>p</em> < 0.001). In a multivariate model, independent predictors of MACCE were pre-existing coronary artery disease (OR 2.45, 95 % CI 1.03–5.80, <em>p</em> = 0.042) and increasing age (OR 1.08, 95 % CI 1.04–1.11, <em>p</em> < 0.001). Patients having surgery for head and neck cancer are at high (>5 %) risk of developing vascular complications. Prior coronary artery disease and increasing age are independent risk factors for MACCE.</p>