Features of the Clinical Course of the Perioperative Period in Patients With Cardiovascular-Kidney-Metabolic Syndrome

Introduction : Recently introduced concept of Cardiovascular-Kidney-Metabolic Syndrome (CVKMS) is defined as a health disorder associated with obesity, diabetes mellitus, chronic kidney disease, cardiovascular disease, and aims to improve a multidisciplinary approach to the prevention, risk stratification, and treatment of these disorders. Aim : To substantiate the feasibility for selection of CVKMS within the framework of metabolic syndrome in anesthesiologic support of extracardiac operations 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). The severity of postoperative complications was classified according to the Clavien-Dindo definitions. The length of postoperative stay was calculated. 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). The rate of postoperative complications of Clavien–Dindo grade II and III was significantly higher in the CVKMS group (p = 0.001 and p < 0.001; respectively). The duration of postoperative hospitalization was significantly longer in the CVKMS group (p = 0.022). Conclusion : Compared to patients with metabolic syndrome, patients with CVKMS have a higher incidence of perioperative adverse events and longer hospitalization after extracardiac surgery. This indicates the expediency of taking it into account when providing anesthesia support in high-risk patients.