|Perioperative Acute Myocardial Infarction Increases Mortality Following Noncardiac Surgery|
|Li, Shuang-Ling; Wang, Dong-Xin; Wu, Xin-Min; Li, Nan; Xie, Ya-Qing|
|关键词||Perioperative Acute Myocardial Infarction Mortality Noncardiac Surgery Survival|
|刊名||JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA|
|WOS标题词||Science & Technology|
|类目[WOS]||Anesthesiology ; Cardiac & Cardiovascular Systems ; Respiratory System ; Peripheral Vascular Disease|
|研究领域[WOS]||Anesthesiology ; Cardiovascular System & Cardiology ; Respiratory System|
Objective: To provide insight into diagnosis, treatment, and prevention of perioperative myocardial infarction (PMI).
Design: The authors retrospectively analyzed PMI characteristics in patients undergoing noncardiac surgery and identified risk factors for death.
Setting: An affiliated teaching hospital with about 1500 beds.
Participants: The authors screened electronic medical records and retrospectively analyzed clinical data from 117,856 patients who underwent noncardiac surgery during the period from August 2003 through June 2011.
Interventions: Patients were divided into two groups based on survival at 30 days after PMI.
Measurements and Main Results: PMI was reported in 61 patients, for an overall incidence rate of 5.2 per 10,000. PMI incidence increased significantly with age, with a rate of 0.97 per 10,000 for the 45- to 60-year-old group, and increasing to a rate of 40.4 per 10,000 for the >75-year-old group (p < 0.001). The mortality rate of non-PMI patients (n = 117,795) was 0.32%, whereas the mortality rate for the 61 PMI patients was 36.1% (p < 0.001). PM! occurred acutely (within 48 to 72 hours of surgery) in the majority of patients (78.7%), and only 18% of these patients complained of chest pain. The majority of patients who suffered PM! had non-ST segment elevation acute myocardial infarction (78.7%). By multiple logistic regression analysis, lack of anticoagulation/antiplatelet therapy and cardiogenic shock were independent risk factors for death in PMI patients (p = 0.001 for both).
Conclusions: PMI incidence increased significantly with advanced age. PMI increased mortality following noncardiac surgery. The independent risk factors for death in PMI patients following noncardiac surgery were lack of anticoagulation/antiplatelet therapy and cardiogenic shock. (C) 2013 Elsevier Inc. All rights reserved.
|作者单位||Peking Univ, Hosp 1, Dept Anesthesiol & Surg Intens Care, Beijing 100034, Peoples R China|
|Li, Shuang-Ling,Wang, Dong-Xin,Wu, Xin-Min,et al. Perioperative Acute Myocardial Infarction Increases Mortality Following Noncardiac Surgery[J]. JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA,2013,27(6):1277-1281.|
|APA||Li, Shuang-Ling,Wang, Dong-Xin,Wu, Xin-Min,Li, Nan,&Xie, Ya-Qing.(2013).Perioperative Acute Myocardial Infarction Increases Mortality Following Noncardiac Surgery.JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA,27(6),1277-1281.|
|MLA||Li, Shuang-Ling,et al."Perioperative Acute Myocardial Infarction Increases Mortality Following Noncardiac Surgery".JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA 27.6(2013):1277-1281.|