Preoperative Stress Testing Varies Widely Across the U.S.

Not infrequently, stress testing is undertaken in patients deemed to be at high cardiovascular (CV) risk prior to elective noncardiac surgery. The goal is to prevent major adverse cardiac events (MACE), but little robust evidence supports this practice. In this study, researchers analyzed administrative claims data from 185,000 patients (mean age, 62) who underwent 1 of 8 common elective surgeries (75% gastrointestinal, 25% vascular) at more than 1000 U.S. hospitals from 2015 to 2019. Hospital-level proportions of patients at high perioperative CV risk and rates of in-hospital MACE (i.e., myocardial infarction, heart failure exacerbation, arrhythmia, revascularization, or death) per 1000 patients undergoing surgery were compared across quin…