PT  - JOURNAL ARTICLE
AU  - Meyer, Stephanie
AU  - McLaughlin, Vallerie V.
AU  - Seyfarth, Hans-Juergen
AU  - Bull, Todd M.
AU  - Vizza, Carmine D.
AU  - Gomberg-Maitland, Mardi
AU  - Preston, Ioana R.
AU  - Barberà, Joan A.
AU  - Hassoun, Paul M.
AU  - Halank, Michael
AU  - Jaïs, Xavier
AU  - Nickel, Nils
AU  - Hoeper, Marius M.
AU  - Humbert, Marc
TI  - Outcomes of noncardiac, nonobstetric surgery in patients with PAH: an international prospective survey
AID  - 10.1183/09031936.00089212
DP  - 2013 Jun 01
TA  - European Respiratory Journal
PG  - 1302--1307
VI  - 41
IP  - 6
4099  - http://erj.ersjournals.com/content/41/6/1302.short
4100  - http://erj.ersjournals.com/content/41/6/1302.full
SO  - Eur Respir J2013 Jun 01; 41
AB  - We conducted an international, prospective, 3-year questionnaire-based survey among 11 pulmonary hypertension centres to assemble data from patients with pulmonary arterial hypertension (PAH) undergoing noncardiac and nonobstetric surgery. Data were collected between July 2007 and June 2010 from 114 patients with PAH (70% female, mean age 57 years) who underwent major surgery. At the time of surgery, 43% were in functional class III/IV. 82% of the interventions were performed under general anaesthesia and 18% under spinal anaesthesia. Major complications occurred in seven (6.1%) of the patients, of whom four died, resulting in an overall perioperative mortality rate of 3.5%. The mortality rate was 15% (two out of 13) in emergency procedures, compared with 2% (two out of 101) in nonemergency procedures (p=0.01). Risk factors for major complications were an elevated right atrial pressure (OR 1.1, 95% CI 1.0–1.3; p=0.01), a 6-min walking distance <399 m at the last preoperative assessment (OR 2.2, 95% CI 1.1–3.7; p=0.04), the perioperative use of vasopressors (OR 1.5, 95% CI 1.2–2.7; p=0.03) and the need for emergency surgery (OR 2.4, 95% CI 1.4–3.6; p=0.01). Major surgery in patients with PAH continues to be a high-risk procedure, particularly when emergency interventions are needed.