{"id":3289,"date":"2010-01-28T00:00:00","date_gmt":"2010-01-28T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/non-invasive-cardiac-stress-testing-before-elective-major-non-cardiac-surgery-population-based-cohort-study\/"},"modified":"2023-06-14T20:05:03","modified_gmt":"2023-06-15T00:05:03","slug":"non-invasive-cardiac-stress-testing-before-elective-major-non-cardiac-surgery-population-based-cohort-study","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/non-invasive-cardiac-stress-testing-before-elective-major-non-cardiac-surgery-population-based-cohort-study\/","title":{"rendered":"Non-invasive cardiac stress testing before elective major non-cardiac surgery: population based cohort study"},"content":{"rendered":"

Objective<\/strong> — To determine the association of non-invasive cardiac stress testing before elective intermediate to high risk non-cardiac surgery with survival and hospital stay.<\/p>\n

Design<\/strong> — Population based retrospective cohort study.<\/p>\n

Setting<\/strong> — Acute care hospitals in Ontario, Canada, between 1 April 1994 and 31 March 2004.<\/p>\n

Participants<\/strong> — Patients aged 40 years or older who underwent specific elective intermediate to high risk non-cardiac surgical procedures.<\/p>\n

Interventions<\/strong> — Non-invasive cardiac stress testing performed within six months before surgery.<\/p>\n

Main Outcome Measures<\/strong> — Postoperative one year survival and length of stay in hospital.<\/p>\n

Results<\/strong> — Of the 271 082 patients in the entire cohort, 23 991 (8.9%) underwent stress testing. After propensity score methods were used to reduce important differences between patients who did or did not undergo preoperative stress testing and assemble a matched cohort (n=46 120), testing was associated with improved one year survival (hazard ratio (HR) 0.92, 95% CI 0.86 to 0.99; P=0.03) and reduced mean hospital stay (difference -0.24 days, 95% CI -0.07 to -0.43; P<0.001). In an analysis of subgroups defined by Revised Cardiac Risk Index (RCRI) class, testing was associated with harm in low risk patients (RCRI 0 points: HR 1.35, 95% CI 1.05 to 1.74), but with benefit in patients who were at intermediate risk (RCRI 1-2 points: 0.92, 95% CI 0.85 to 0.99) or high risk (RCRI 3-6 points: 0.80, 95% CI 0.67 to 0.97).<\/p>\n

Conclusions<\/strong> — Preoperative non-invasive cardiac stress testing is associated with improved one year survival and length of hospital stay in patients undergoing elective intermediate to high risk non-cardiac surgery. These benefits principally apply to patients with risk factors for perioperative cardiac complications.<\/p>\n","protected":false},"excerpt":{"rendered":"

Objective — To determine the association of non-invasive cardiac stress testing before elective intermediate to high risk non-cardiac surgery with survival and hospital stay. Design — Population based retrospective cohort study. Setting — Acute care hospitals in Ontario, Canada, between 1 April 1994 and 31 March 2004. Participants — Patients aged 40 years or older […]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[40,35,25],"migration-helper-qa-sample-set":[],"class_list":["post-3289","journal_article","type-journal_article","status-publish","hentry","topic-cardiovascular-disease","topic-public-health","topic-surgery"],"acf":{"citation":"Wijeysundera DN, Beattie WS, Austin PC, Hux JE, Laupacis A. BMJ<\/em>. 2010; 340:b5526.","source_url":"http:\/\/www.bmj.com\/content\/340\/bmj.b5526?view=long&pmid=20110306","ices_scientist":[1132,1385,1268,1293],"site":[6733],"research_program":[6742,6746],"news_release":[7767],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"248107BB-5A23-497C-94E7-D4997A588FD9","sitecore_item_name":"Non-invasive-cardiac-stress-testing-before-elective-major-non-cardiac-surgery-population-based","sitecore_field_values":"{\n \"Title\": \"Non-invasive cardiac stress testing before elective major non-cardiac surgery: population based cohort study\",\n \"Short title\": \"Non-invasive cardiac stress testing\",\n \"Citation\": \"

Wijeysundera DN, Beattie WS, Austin PC, Hux JE, Laupacis A. BMJ<\/em>. 2010; 340:b5526.<\/p>\",\n \"Abstract\": \"

Objective<\/strong> — To determine the association of non-invasive cardiac stress testing before elective intermediate to high risk non-cardiac surgery with survival and hospital stay.<\/p>n

Design<\/strong> — Population based retrospective cohort study.<\/p>n

Setting<\/strong> — Acute care hospitals in Ontario, Canada, between 1 April 1994 and 31 March 2004.<\/p>n

Participants<\/strong> — Patients aged 40 years or older who underwent specific elective intermediate to high risk non-cardiac surgical procedures.<\/p>n

Interventions<\/strong> — Non-invasive cardiac stress testing performed within six months before surgery.<\/p>n

Main Outcome Measures<\/strong> — Postoperative one year survival and length of stay in hospital.<\/p>n

Results<\/strong> — Of the 271 082 patients in the entire cohort, 23 991 (8.9%) underwent stress testing. After propensity score methods were used to reduce important differences between patients who did or did not undergo preoperative stress testing and assemble a matched cohort (n=46 120), testing was associated with improved one year survival (hazard ratio (HR) 0.92, 95% CI 0.86 to 0.99; P=0.03) and reduced mean hospital stay (difference -0.24 days, 95% CI -0.07 to -0.43; P<0.001). In an analysis of subgroups defined by Revised Cardiac Risk Index (RCRI) class, testing was associated with harm in low risk patients (RCRI 0 points: HR 1.35, 95% CI 1.05 to 1.74), but with benefit in patients who were at intermediate risk (RCRI 1-2 points: 0.92, 95% CI 0.85 to 0.99) or high risk (RCRI 3-6 points: 0.80, 95% CI 0.67 to 0.97).<\/p>n

Conclusions<\/strong> — Preoperative non-invasive cardiac stress testing is associated with improved one year survival and length of hospital stay in patients undergoing elective intermediate to high risk non-cardiac surgery. These benefits principally apply to patients with risk factors for perioperative cardiac complications.<\/p>n

View full text<\/a><\/p>\",\n \"Keywords\": \"{92E2791D-5DAB-4244-8A85-434D524D9A12}|{9F514AF9-2526-48FE-8414-54C443CF99AD}|{D41CE091-DCDC-475E-9E15-4BC16AEE1D81}\",\n \"Related Products\": \"

News Release<\/h2>rn

High risk patients less likely to die if they undergo stress testing before surgery but low risk patients may be harmed<\/a><\/h3>\",\n \"Research Programs\": \"{BEC72DE0-BA8C-42B8-ACE5-EE29FFB2CB3B}|{CFE36C89-C969-4C23-B5E4-1BA9E5BDC273}\",\n \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n \"ICES Scientists\": \"{22E01D03-965E-4F09-9CC2-6BC40EC9403D}|{7D498E8B-5801-4F9E-AC41-11ED50F3C34E}|{4C08D086-0DAC-4164-B8DF-54317B959A2C}|{83920C20-06BE-4C6B-9FA7-06B69A509A24}\",\n \"Posted Date\": \"20100128T000000\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2010\/January\/Non-invasive-cardiac-stress-testing-before-elective-major-non-cardiac-surgery-population-based"},"yoast_head":"\nICES | Non-invasive cardiac stress testing before elective major non-cardiac surgery: population based cohort study<\/title>\n<meta name=\"description\" content=\"Objective — To determine the association of non-invasive cardiac stress testing before elective intermediate to high risk non-cardiac surgery with\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/non-invasive-cardiac-stress-testing-before-elective-major-non-cardiac-surgery-population-based-cohort-study\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | Non-invasive cardiac stress testing before elective major non-cardiac surgery: population based cohort study\" \/>\n<meta property=\"og:description\" content=\"Objective — To determine the association of non-invasive cardiac stress testing before elective intermediate to high risk non-cardiac surgery with\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/non-invasive-cardiac-stress-testing-before-elective-major-non-cardiac-surgery-population-based-cohort-study\/\" \/>\n<meta property=\"og:site_name\" content=\"ICES\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ICESOntario\/\" \/>\n<meta property=\"article:modified_time\" content=\"2023-06-15T00:05:03+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/non-invasive-cardiac-stress-testing-before-elective-major-non-cardiac-surgery-population-based-cohort-study\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/non-invasive-cardiac-stress-testing-before-elective-major-non-cardiac-surgery-population-based-cohort-study\\\/\",\"name\":\"ICES | Non-invasive cardiac stress testing before elective major non-cardiac surgery: population based cohort study\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\"},\"datePublished\":\"2010-01-28T05:00:00+00:00\",\"dateModified\":\"2023-06-15T00:05:03+00:00\",\"description\":\"Objective — To determine the association of non-invasive cardiac stress testing before elective intermediate to high risk non-cardiac surgery with\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/non-invasive-cardiac-stress-testing-before-elective-major-non-cardiac-surgery-population-based-cohort-study\\\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/non-invasive-cardiac-stress-testing-before-elective-major-non-cardiac-surgery-population-based-cohort-study\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/non-invasive-cardiac-stress-testing-before-elective-major-non-cardiac-surgery-population-based-cohort-study\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Journal Articles\",\"item\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Non-invasive cardiac stress testing before elective major non-cardiac surgery: population based cohort study\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\",\"name\":\"ICES\",\"description\":\"POPULATION-BASED HEALTH RESEARCH THAT MAKES A DIFFERENCE\",\"publisher\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#organization\"},\"alternateName\":\"Institute for Clinical Evaluative Sciences\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"fr-FR\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#organization\",\"name\":\"ICES\",\"alternateName\":\"Institute for Clinical Evaluative Sciences\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/wp-content\\\/uploads\\\/2023\\\/04\\\/ices-logo.png\",\"contentUrl\":\"https:\\\/\\\/www.ices.on.ca\\\/wp-content\\\/uploads\\\/2023\\\/04\\\/ices-logo.png\",\"width\":\"676\",\"height\":\"618\",\"caption\":\"ICES\"},\"image\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/ICESOntario\\\/\",\"https:\\\/\\\/www.linkedin.com\\\/company\\\/ices-research-institute\\\/\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"ICES | Non-invasive cardiac stress testing before elective major non-cardiac surgery: population based cohort study","description":"Objective — To determine the association of non-invasive cardiac stress testing before elective intermediate to high risk non-cardiac surgery with","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/non-invasive-cardiac-stress-testing-before-elective-major-non-cardiac-surgery-population-based-cohort-study\/","og_locale":"fr_FR","og_type":"article","og_title":"ICES | Non-invasive cardiac stress testing before elective major non-cardiac surgery: population based cohort study","og_description":"Objective — To determine the association of non-invasive cardiac stress testing before elective intermediate to high risk non-cardiac surgery with","og_url":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/non-invasive-cardiac-stress-testing-before-elective-major-non-cardiac-surgery-population-based-cohort-study\/","og_site_name":"ICES","article_publisher":"https:\/\/www.facebook.com\/ICESOntario\/","article_modified_time":"2023-06-15T00:05:03+00:00","og_image":[{"width":1200,"height":675,"url":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/non-invasive-cardiac-stress-testing-before-elective-major-non-cardiac-surgery-population-based-cohort-study\/","url":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/non-invasive-cardiac-stress-testing-before-elective-major-non-cardiac-surgery-population-based-cohort-study\/","name":"ICES | Non-invasive cardiac stress testing before elective major non-cardiac surgery: population based cohort study","isPartOf":{"@id":"https:\/\/www.ices.on.ca\/fr\/#website"},"datePublished":"2010-01-28T05:00:00+00:00","dateModified":"2023-06-15T00:05:03+00:00","description":"Objective — To determine the association of non-invasive cardiac stress testing before elective intermediate to high risk non-cardiac surgery with","breadcrumb":{"@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/non-invasive-cardiac-stress-testing-before-elective-major-non-cardiac-surgery-population-based-cohort-study\/#breadcrumb"},"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/non-invasive-cardiac-stress-testing-before-elective-major-non-cardiac-surgery-population-based-cohort-study\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/non-invasive-cardiac-stress-testing-before-elective-major-non-cardiac-surgery-population-based-cohort-study\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.ices.on.ca\/fr\/"},{"@type":"ListItem","position":2,"name":"Journal Articles","item":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/"},{"@type":"ListItem","position":3,"name":"Non-invasive cardiac stress testing before elective major non-cardiac surgery: population based cohort study"}]},{"@type":"WebSite","@id":"https:\/\/www.ices.on.ca\/fr\/#website","url":"https:\/\/www.ices.on.ca\/fr\/","name":"ICES","description":"POPULATION-BASED HEALTH RESEARCH THAT MAKES A DIFFERENCE","publisher":{"@id":"https:\/\/www.ices.on.ca\/fr\/#organization"},"alternateName":"Institute for Clinical Evaluative Sciences","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.ices.on.ca\/fr\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"fr-FR"},{"@type":"Organization","@id":"https:\/\/www.ices.on.ca\/fr\/#organization","name":"ICES","alternateName":"Institute for Clinical Evaluative Sciences","url":"https:\/\/www.ices.on.ca\/fr\/","logo":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/www.ices.on.ca\/fr\/#\/schema\/logo\/image\/","url":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2023\/04\/ices-logo.png","contentUrl":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2023\/04\/ices-logo.png","width":"676","height":"618","caption":"ICES"},"image":{"@id":"https:\/\/www.ices.on.ca\/fr\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/ICESOntario\/","https:\/\/www.linkedin.com\/company\/ices-research-institute\/"]}]}},"_links":{"self":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/journal_article\/3289","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/journal_article"}],"about":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/types\/journal_article"}],"acf:post":[{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/news_release\/7767"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/research_program\/6746"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/research_program\/6742"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/site\/6733"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1293"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1268"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1385"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1132"}],"wp:attachment":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/media?parent=3289"}],"wp:term":[{"taxonomy":"migration-helper-automated","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-helper-automated?post=3289"},{"taxonomy":"migration-manual","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-manual?post=3289"},{"taxonomy":"topic","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/topic?post=3289"},{"taxonomy":"migration-helper-qa-sample-set","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-helper-qa-sample-set?post=3289"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}