Analysis of the relationship between lifestyle and postoperative cardiac and cerebrovascular complications after major abdominal surgery: a cohort study

Background: This study investigated the association between lifestyle-related factors and the risk of cardiac and cerebrovascular disease in patients who underwent major abdominal surgery, using the Korean National Health Insurance Service (NHIS) data. Methods: We analyzed individuals aged >40 years who received health check-ups between 2009 and 2018. Among these data, we enrolled 108,261 patients who underwent major abdominal surgery and were followed-up to assess the development of cardiac or cerebrovascular disease for 1 year after surgery. Logistic regression was used to evaluate the association between lifestyle-related factors — body mass index, metabolic syndrome, alcohol consumption, cigarette smoking, and physical activity —and the outcomes. Results: Patients with metabolic syndrome and current smokers had a significantly higher risk of developing both cardiac and cerebrovascular disease within 1 year after major abdominal surgery. Ex-smokers and overweight patients had a higher risk of postoperative cerebrovascular disease. Alcohol consumption was associated with a reduced risk of cardiac disease and high levels of physical activity were linked to a reduced risk of cerebrovascular events. Conclusion: Our data suggest that lifestyle modification including weight control and cessation of smoking before undergoing major abdominal surgery may prevent postoperative cardiac and cerebrovascular risks.