Siv Fonnes1, Ismail Gögenur2, Edith Smed Søndergaard3, Volkert Dirk Siersma4, Lars Nannestad Jorgensen5, Jørn Wetterslev6, Christian Sahlholt Meyhoff7. 1. Centre for Perioperative Optimisation, Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, DK-2730 Herlev, Denmark. Electronic address: siv.fonnes@gmail.com. 2. Department of Surgery, Køge Hospital, University of Copenhagen, Lykkebækvej 1, DK-4600 Køge, Denmark. Electronic address: igo@regionsjaelland.dk. 3. Department of Anaesthesiology, Slagelse Hospital, Fælledvej 11, DK-4200 Slagelse, Denmark. Electronic address: edith_00@hotmail.com. 4. The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014 Copenhagen C, Denmark. Electronic address: siersma@sund.ku.dk. 5. Digestive Disease Centre, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Bispebjerg Bakke 23, DK-2400 Copenhagen, NV, Denmark. Electronic address: larsnjorgensen@hotmail.com. 6. Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen E, Denmark. Electronic address: wetterslev@ctu.dk. 7. Department of Anaesthesiology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Bispebjerg Bakke 23, DK-2400 Copenhagen NV, Denmark. Electronic address: christianmeyhoff@gmail.com.
Abstract
BACKGROUND:Increased long-term mortality was found in patients exposed to perioperative hyperoxia in the PROXI trial, where patients undergoing laparotomy were randomised to 80% versus 30% oxygen during and after surgery. This post hoc follow-up study assessed the impact of perioperative hyperoxia on long-term risk of cardiovascular events. METHODS: A total of 1386 patients undergoing either elective or emergency laparotomy were randomised to 80% versus 30% oxygen during and two hours after surgery. At follow-up, the primary outcome of acute coronary syndrome was assessed. Secondary outcomes included myocardial infarction, other heart disease, and acute coronary syndrome or death. Data were analysed in the Cox proportional hazards model. RESULTS: The primary outcome, acute coronary syndrome, occurred in 2.5% versus 1.3% in the 80% versus 30% oxygen group; HR 2.15 (95% CI 0.96-4.84). Patients in the 80% oxygen group had significantly increased risk of myocardial infarction; HR 2.86 (95% CI 1.10-7.44), other heart disease; HR 1.40 (95% 1.06-1.83), and acute coronary syndrome or death; HR 1.22 (95% CI 1.01-1.49). CONCLUSIONS: Perioperative hyperoxia may be associated with an increased long-term risk of myocardial infarction and other heart disease.
RCT Entities:
BACKGROUND: Increased long-term mortality was found in patients exposed to perioperative hyperoxia in the PROXI trial, where patients undergoing laparotomy were randomised to 80% versus 30% oxygen during and after surgery. This post hoc follow-up study assessed the impact of perioperative hyperoxia on long-term risk of cardiovascular events. METHODS: A total of 1386 patients undergoing either elective or emergency laparotomy were randomised to 80% versus 30% oxygen during and two hours after surgery. At follow-up, the primary outcome of acute coronary syndrome was assessed. Secondary outcomes included myocardial infarction, other heart disease, and acute coronary syndrome or death. Data were analysed in the Cox proportional hazards model. RESULTS: The primary outcome, acute coronary syndrome, occurred in 2.5% versus 1.3% in the 80% versus 30% oxygen group; HR 2.15 (95% CI 0.96-4.84). Patients in the 80% oxygen group had significantly increased risk of myocardial infarction; HR 2.86 (95% CI 1.10-7.44), other heart disease; HR 1.40 (95% 1.06-1.83), and acute coronary syndrome or death; HR 1.22 (95% CI 1.01-1.49). CONCLUSIONS: Perioperative hyperoxia may be associated with an increased long-term risk of myocardial infarction and other heart disease.
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