Risk factors in patients undergoing major nonvascular abdominal operations that predict perioperative myocardial infarction.
BACKGROUND
Perioperative myocardial infarction (PMI) is an uncommon but serious complication of major abdominal surgery. Identifying the patients at risk may potentially reduce morbidity and mortality. In this study we determined risk factors associated with PMI in patients undergoing abdominal, nonvascular surgery (ANVS).


METHODS
The utility of risk factors for PMI using Goldman's criteria and nine other variables were compared in patients diagnosed with PMI after ANVS (group I) and a control group (group II) matched for age, gender, and type of operation.


RESULTS
Thirty-four patients, 21 men and 13 women, with a mean age of 70 years were diagnosed with PMI, which was associated with a 41% mortality rate (14 of 34). Risk factors for PMI included poor general condition, congestive heart failure, abnormal cardiac rhythm, smoking, previous myocardial infarction (MI), and emergent operation.


CONCLUSIONS
Although PMI following ANVS is uncommon, the mortality rate remains high. Patients classified as Goldman's class III and IV, or with a history of cigarette smoking, previous MI, or angina merit further evaluation in order to reduce the incidence of this complication.
Gedebou
T M
TM
Department of Surgery, University of Arizona, Health Sciences Center, Tucson, USA.
Barr
S T
ST
Hunter
G
G
Sinha
R
R
Rappaport
W
W
VillaReal
K
K
D000005:Abdomen / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000401:mortality; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors