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Cardiovascular events after orthopedic surgery: Who is at risk?

Abstract:

Orthopedic surgery (OS) encompasses effective interventions for injuries or disorders of the musculoskeletal system. Nonetheless, approximately 5% of patients who undergo this type of surgery develop cardiovascular events (CE), with an elevated morbidity rate. Various potential factors have been highlighted to identify and stratify patients at risk of these complications. Among these factors various stand out, including cardiometabolic disease, previous CE, rheumatoid arthritis, older age, injury site, and the surgical procedure, with hip and spine surgeries exhibiting the largest CE risk. Therefore, diverse preventive strategies have been implemented such as pharmacotherapy with hypolipemics, beta-blockers, and antithrombotic drugs. Nevertheless, a greater amount of randomized clinical assays is required with representative samples in order to establish specific criteria for the preventive approach to patients at risk of CE post-OS. The objective of this article is to describe the characteristics of the population of patients at risk of CE post-OS and how to identify them, as well as to explain the possible tools healthcare personnel may utilize to assess CE risk in these patients to execute an opportune therapeutic and preventive approach.