PDF(Pubmed)
Abstract：
UNASSIGNED: Maxillofacial surgeries, including procedures to the face, oral cavity, jaw, and head and neck, are common in adults. However, they impose a risk of adverse cardiac events (ACEs). While ACEs are well understood for other non-cardiac surgeries, there is a paucity of data about maxillofacial surgeries. This systematic review and meta-analysis report the incidence and presentation of perioperative ACEs during maxillofacial surgery.
UNASSIGNED: We included primary studies that reported on perioperative ACEs in adults. To standardise reporting, ACEs were categorised as 1. heart rate and rhythm disturbances, 2. blood pressure disturbances, 3. ischaemic heart disease and 4. heart failure and other complications. The primary outcome was ACE presentation and incidence during the perioperative period. Secondary outcomes included the surgical outcome according to the Clavien-Dindo classification and trigeminocardiac reflex involvement. STATA version 17.0 and MetaProp were used to delineate proportion as effect size with a 95% confidence interval (CI).
UNASSIGNED: Twelve studies (34,227 patients) were included. The incidence of perioperative ACEs was 2.58% (95% CI 1.70, 3.45, I2 = 96.17%, P = 0.001). Heart rate and rhythm disturbances resulted in the greatest incidence at 3.84% among the four categories. Most commonly, these ACEs resulted in intensive care unit admission (i.e. Clavien-Dindo score of 4).
UNASSIGNED: Despite an incidence of 2.58%, ACEs can disproportionately impact surgical outcomes. Future research should include large-scale prospective studies that may provide a better understanding of the contributory factors and long-term effects of ACEs in patients during maxillofacial surgery.
UNASSIGNED: We included primary studies that reported on perioperative ACEs in adults. To standardise reporting, ACEs were categorised as 1. heart rate and rhythm disturbances, 2. blood pressure disturbances, 3. ischaemic heart disease and 4. heart failure and other complications. The primary outcome was ACE presentation and incidence during the perioperative period. Secondary outcomes included the surgical outcome according to the Clavien-Dindo classification and trigeminocardiac reflex involvement. STATA version 17.0 and MetaProp were used to delineate proportion as effect size with a 95% confidence interval (CI).
UNASSIGNED: Twelve studies (34,227 patients) were included. The incidence of perioperative ACEs was 2.58% (95% CI 1.70, 3.45, I2 = 96.17%, P = 0.001). Heart rate and rhythm disturbances resulted in the greatest incidence at 3.84% among the four categories. Most commonly, these ACEs resulted in intensive care unit admission (i.e. Clavien-Dindo score of 4).
UNASSIGNED: Despite an incidence of 2.58%, ACEs can disproportionately impact surgical outcomes. Future research should include large-scale prospective studies that may provide a better understanding of the contributory factors and long-term effects of ACEs in patients during maxillofacial surgery.
摘要：
■颌面手术，包括面部的程序，口腔,下巴,头部和颈部，在成年人中很常见。然而,它们具有不良心脏事件(ACE)的风险.虽然ACEs在其他非心脏手术中很好理解，关于颌面手术的数据很少。本系统评价和荟萃分析报告了颌面外科围手术期ACE的发生率和表现。
■我们纳入了关于成人围手术期ACE的主要研究。为了使报告标准化，ACE分类为1。心率和节律紊乱，2.血压紊乱,3.缺血性心脏病和4.心力衰竭和其他并发症。主要结果是围手术期的ACE表现和发生率。次要结果包括根据Clavien-Dindo分类和三叉神经心脏反射受累的手术结果。使用STATA17.0版和MetaProp将比例描述为效应大小，置信区间为95％（CI）。
■纳入了12项研究（34,227例患者）。围手术期ACEs的发生率为2.58%(95%CI1.70,3.45,I2=96.17%,P=0.001)。在四个类别中，心率和节律紊乱的发生率最高，为3.84％。最常见的是,这些ACE导致重症监护病房入院(即Clavien-Dindo得分为4分).
■尽管发病率为2.58%,ACE可以不成比例地影响手术结果。未来的研究应包括大规模的前瞻性研究，这些研究可能会更好地了解颌面外科手术患者中ACE的促成因素和长期影响。
■我们纳入了关于成人围手术期ACE的主要研究。为了使报告标准化，ACE分类为1。心率和节律紊乱，2.血压紊乱,3.缺血性心脏病和4.心力衰竭和其他并发症。主要结果是围手术期的ACE表现和发生率。次要结果包括根据Clavien-Dindo分类和三叉神经心脏反射受累的手术结果。使用STATA17.0版和MetaProp将比例描述为效应大小，置信区间为95％（CI）。
■纳入了12项研究（34,227例患者）。围手术期ACEs的发生率为2.58%(95%CI1.70,3.45,I2=96.17%,P=0.001)。在四个类别中，心率和节律紊乱的发生率最高，为3.84％。最常见的是,这些ACE导致重症监护病房入院(即Clavien-Dindo得分为4分).
■尽管发病率为2.58%,ACE可以不成比例地影响手术结果。未来的研究应包括大规模的前瞻性研究，这些研究可能会更好地了解颌面外科手术患者中ACE的促成因素和长期影响。
