Features of perioperative period in patients with cardiovascular-kidney-metabolic syndrome

Background. The recent concept of cardiovascular-kidney-metabolic syndrome (CVKMS) is defined as a health disorders associated with obesity, diabetes mellitus, chronic kidney disease and cardiovascular diseases. This concept is aimed at improving the multidisciplinary approach to prevention, risk stratification and treatment of these disorders. Objective. To substantiate the feasibility for selection of CVKMS within metabolic syndrome in anesthetic support of non-cardiac surgeries in high-risk patients. Material and methods. One hundred and two patients were divided into the CVKMS group (n=34) and the metabolic syndrome group (n=68). Severity of postoperative complications was classified according to the Clavien—Dindo definitions. Length of postoperative hospital-stay was analyzed. Results. Patients with CVKMS had a significantly higher rate of metabolic syndrome components: arterial hypertension, obesity and diabetes mellitus (p<0.005 for all comparisons). The number of patients with complications was significantly higher in the CVKMS group (p=0.005). Postoperative complications Clavien–Dindo grade II and III were significantly more common in the CVKMS group (p=0.001 and p< 0.001; respectively). Length of postoperative hospital-stay was significantly longer in the CVKMS group (p=0.022). Conclusion. Compared to metabolic syndrome, patients with CVKMS have a higher incidence of perioperative adverse events and longer hospital-stay after non-cardiac surgery. Thus, CVKMS should be considered when providing anesthetic support in high-risk patients.