INTRODUCTION: The study objective was to ascertain the incidence of bleeding and ischemic complications related to acute and planned orthopedic surgery in patients with known cardiovascular diseases. MATERIALS AND METHODS: The study conducted between 2010 and 2013 enrolled 477 patients (289 women, 188 men) with a diagnosed cardiovascular disease or a history of thromboembolic event. Aside from gender, age, height and weight, the study observed other anamnestic data and perioperative laboratory test results that may impact on a bleeding or ischemic event. RESULTS: Two hundred seventy-two (57 %) patients had acute surgery, and 205 (43 %) patients had elective surgery. Complications arose in 55 (11.6 %) patients, 32 (6.9 %) had bleeding complications, 19 (4.0 %) ischemic complications, and both complications were experienced by 4 (0.8 %) patients. Bleeding developed in 14 (5.1 %) patients who had acute surgery, and in 22 (10.7 %) who had elective surgery. Twenty-two (8.1 %) patients having acute surgery and one (0.1 %) undergoing elective surgery suffered from ischemic complications. The incidence of bleeding complications was significantly higher in elective surgery (p = 0.026, OR 2.22), and when adjusted (general anaesthesia, gender, and use of warfarin), the difference was even higher (p = 0.015, OR 2.44), whereas the occurrence of ischemic complications was significantly higher in acute surgery (p = 0.005, OR 18.0), and when adjusted (age), the difference remained significant (p = 0.044, OR 8.3). CONCLUSIONS: The study noted a significantly higher incidence of bleeding complications in elective orthopedic surgery when compared with acute surgery. Conversely, the incidence of ischemic complications was significantly higher in patients having acute orthopedic surgery when compared with those operated on electively.

3rd Department of Internal Medicine Cardiology 3rd Faculty of Medicine of Charles University and University Hospital Kralovske Vinohrady Srobarova 50 100 34 Prague Czech Republic

Department of Anesthaesiology and Resuscitation 3rd Faculty of Medicine of Charles University and University Hospital Kralovske Vinohrady Srobarova 50 100 34 Prague Czech Republic

Department of Orthopedics and Traumatology 3rd Faculty of Medicine of Charles University and University Hospital Kralovske Vinohrady Srobarova 50 100 34 Prague Czech Republic

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$a Džupa, Valér, $u Department of Orthopedics and Traumatology, Third Faculty of Medicine of Charles University and University Hospital Kralovske Vinohrady, Srobarova 50, 100 34, Prague, Czech Republic. valer.dzupa@fnkv.cz. $d 1962- $7 pna2005262027

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$a Risk comparison of bleeding and ischemic perioperative complications after acute and elective orthopedic surgery in patients with cardiovascular disease / $c V. Džupa, P. Waldauf, Z. Moťovská, P. Widimský, M. Ondráková, R. Bartoška, M. Ježek, T. Lena, O. Popelka, M. Krbec,

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$a INTRODUCTION: The study objective was to ascertain the incidence of bleeding and ischemic complications related to acute and planned orthopedic surgery in patients with known cardiovascular diseases. MATERIALS AND METHODS: The study conducted between 2010 and 2013 enrolled 477 patients (289 women, 188 men) with a diagnosed cardiovascular disease or a history of thromboembolic event. Aside from gender, age, height and weight, the study observed other anamnestic data and perioperative laboratory test results that may impact on a bleeding or ischemic event. RESULTS: Two hundred seventy-two (57 %) patients had acute surgery, and 205 (43 %) patients had elective surgery. Complications arose in 55 (11.6 %) patients, 32 (6.9 %) had bleeding complications, 19 (4.0 %) ischemic complications, and both complications were experienced by 4 (0.8 %) patients. Bleeding developed in 14 (5.1 %) patients who had acute surgery, and in 22 (10.7 %) who had elective surgery. Twenty-two (8.1 %) patients having acute surgery and one (0.1 %) undergoing elective surgery suffered from ischemic complications. The incidence of bleeding complications was significantly higher in elective surgery (p = 0.026, OR 2.22), and when adjusted (general anaesthesia, gender, and use of warfarin), the difference was even higher (p = 0.015, OR 2.44), whereas the occurrence of ischemic complications was significantly higher in acute surgery (p = 0.005, OR 18.0), and when adjusted (age), the difference remained significant (p = 0.044, OR 8.3). CONCLUSIONS: The study noted a significantly higher incidence of bleeding complications in elective orthopedic surgery when compared with acute surgery. Conversely, the incidence of ischemic complications was significantly higher in patients having acute orthopedic surgery when compared with those operated on electively.

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$a Moťovská, Zuzana $u Third Department of Internal Medicine, Cardiology, Third Faculty of Medicine of Charles University and University Hospital Kralovske Vinohrady, Srobarova 50, 100 34, Prague, Czech Republic. $7 xx0104795

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$a Widimský, Petr, $u Third Department of Internal Medicine, Cardiology, Third Faculty of Medicine of Charles University and University Hospital Kralovske Vinohrady, Srobarova 50, 100 34, Prague, Czech Republic. $d 1954- $7 jn20000402682

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$a Ondráková, Martina $u Third Department of Internal Medicine, Cardiology, Third Faculty of Medicine of Charles University and University Hospital Kralovske Vinohrady, Srobarova 50, 100 34, Prague, Czech Republic. $7 xx0210893

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$a Bartoška, Radek $u Department of Orthopedics and Traumatology, Third Faculty of Medicine of Charles University and University Hospital Kralovske Vinohrady, Srobarova 50, 100 34, Prague, Czech Republic. $7 xx0105150

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$a Ježek, Michal $u Department of Orthopedics and Traumatology, Third Faculty of Medicine of Charles University and University Hospital Kralovske Vinohrady, Srobarova 50, 100 34, Prague, Czech Republic. $7 xx0210895

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$a Lena, Tomáš, $u Department of Orthopedics and Traumatology, Third Faculty of Medicine of Charles University and University Hospital Kralovske Vinohrady, Srobarova 50, 100 34, Prague, Czech Republic. $d 1976- $7 xx0210894

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