[Assessment of the surgical risk. Is the time between myocardial infarction and a possible surgical procedure of significance for a surgical risk?].
During a five year period, 320 patients suffered from acute myocardial infarction (AMI) and within the next twelve months became candidates for surgery for either appendicitis (99 patients) or for a hip fracture (221 patients). An evaluation of the mortality at the second event (i.e. appendicitis or hip fracture) in relation to the time between AMI and second event, was done following the intention to treat principle. Appendicitis occurred with the same incidence during all 12 months following AMI. The second event mortality was independent of the time interval from AMI to second event. Age, infarction prior to index infarction and congestive heart failure were prognostically important in relation to second event mortality, but did not affect the constant second event mortality during the first year following AMI. Hip fracture occurred more often during the first months following AMI, where the second event mortality was highest. Congestive heart failure either prior to index infarction or at the index infarction was prognostically important in relation to second event mortality. The relatively high mortality in the first months after AMI could partly be explained by an association between congestive heart failure and hip fracture in the first months after AMI. We conclude that the "operative" mortality in patients with recent AMI is high. The mortality is related to congestive heart failure and not to the time between AMI and surgery.
Kjøller
E
E
Medicinsk kardiologisk afdeling B. Righospitalet, København.
Dirksen
A
A
D001062:Appendectomy; D001064:Appendicitis / Q000601:surgery; D005260:Female; D006620:Hip Fractures / Q000601:surgery; D006801:Humans; D007431:Intraoperative Complications / Q000401:mortality; D008297:Male; D009203:Myocardial Infarction / Q000150:complications*; D011183:Postoperative Complications / Q000401:mortality; D012307:Risk Factors; D013997:Time Factors
Operationsrisikovurdering. Er tiden fra et myokardieninfarkt indtil eventuel operation af betydning for operationsrisikoen?