Deciding the optimal time for surgery in patients with pre-existing comorbid disease is complex. A careful balance of risks is required to weigh up the therapeutic benefits of surgery against an increased risk of perioperative adverse outcomes, whereas the subsequent risk of adverse events and mortality is more dependent on pre-existing conditions. A study in a recent issue of BJA shows that people with a previous cardiovascular or cerebrovascular event within 10 yr of elective surgery were at a higher risk of major adverse cardiovascular events within 1 yr from surgery and that an at-risk period existed if surgery occurred within 37 months of the preoperative event. Before this observation can be used to inform clinical decision-making, caution is needed to interpret these findings because of biases introduced by the analytical approach and potential confounding.

中文翻译：

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改善高危合并症患者手术时间的决策。


确定已有合并症的患者手术的最佳时间很复杂。需要仔细权衡风险，以权衡手术的治疗益处与围手术期不良结局风险的增加，而随后的不良事件和死亡风险更多地取决于既往病症。最近一期 BJA 上的一项研究表明，在择期手术后 10 年内有过心血管或脑血管事件史的人在手术后 1 年内发生主要不良心血管事件的风险更高，如果手术发生在术前事件后 37 个月内，则存在风险期。在将此观察结果用于为临床决策提供信息之前，由于分析方法引入的偏倚和潜在的混杂因素，需要谨慎解释这些发现。