南方医科大学学报2026，Vol.46Issue(6)：1301-1312,12.DOI:10.12122/j.issn.1673-4254.2026.06.10
术前心内科会诊对非心脏手术患者主要不良心脏事件的影响:一项回顾性队列研究
Impact of preoperative cardiology consultation on major adverse cardiac events in non-cardiac surgery patients:a retrospective cohort study
摘要
Abstract
Objective To investigate whether preoperative cardiology consultation reduces the incidence of major adverse cardiac events(MACE)in patients undergoing non-cardiac surgeries.Methods This cohort study was conducted among 7019 elderly patients(above 65 years)with abnormal ECGs undergoing non-cardiac surgeries.The main outcome was MACE occurrence within 30 days post-surgery.The patients were divided into model development and validation cohorts in a 7:3 ratio,and each cohort was categorized into two subgroups with high-risk and low-risk abnormal ECG.MACE prediction models were constructed for the subgroups,and their predictive power was evaluated using ROC curves;the value of preoperative cardiology consultation for reducing MACE was assessed using decision curve analysis.Results Among the 4914 patients in the model development cohort,61 of the 3010 patients with low-risk abnormal ECGs experienced MACE(2.0%),as compared with 59 out of 1904 patients(3.1%)in the high-risk group.The predictive model for MACE for the low-risk group contained 6 risk factors(AUC=0.772),and that for the high-risk group contained 5 risk factors(AUC=0.769).In patients with low-risk abnormal ECG,undergoing cardiovascular specialist consultation did not show significant benefits(the survival rate for predicting MACE was 0.02).However,in patients with high-risk abnormal ECG and those with low-risk abnormal ECG but having specific risk factors,undergoing cardiovascular specialist consultation showed significant benefits with survival rates for predicting MACE of 0.3 and 0.229,respectively.Conclusion For patients with high-risk abnormal ECG and those with low-risk abnormal ECG and specific risk factors,preoperative cardiology consultation may help to reduce the occurrence of MACE following non-cardiac surgeries,but for patients with simple low-risk abnormal ECG cases without risk factors,preoperative cardiology consultation can be omitted,which does not affect the incidence of MACE but can improve medical efficiency.关键词
异常心电图/术前心内科会诊/主要不良心脏事件/老年患者Key words
abnormal electrocardiogram/preoperative cardiology consultation/major adverse cardiac events/elderly patients引用本文复制引用
王沛齐,张凯,王海军,杨路加,刘艳红,曹江北,李皓,米卫东,娄景盛..术前心内科会诊对非心脏手术患者主要不良心脏事件的影响:一项回顾性队列研究[J].南方医科大学学报,2026,46(6):1301-1312,12.基金项目
国家重点研发计划(2018YFC2001900) Supported by the National Key Research and Development Program of China(2018YFC2001900). （2018YFC2001900）
