Risk factors for perioperative myocardial infarction in aged patients undergoing nonneurologic and noncardiac surgery
10.3760/cma.j.issn.0254-9026.2018.07.010
- VernacularTitle:非心脏非神经外科手术围术期老年患者心肌梗死危险因素分析
- Author:
Lan WANG
1
;
Danjie GUO
;
Yi FENG
;
Bailin JIANG
;
Yixuan LI
;
Shangzhi ZOU
;
Lin XUE
Author Information
1. 100044,北京大学人民医院心血管内科急性心肌梗死早期预警和干预北京市重点实验室心血管转化医学研究中心
- Keywords:
Intraoperative period;
Myocardial infarction;
Risk factors
- From:
Chinese Journal of Geriatrics
2018;37(7):768-771
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the risk factors for perioperative myocardial infarction(PMI) in aged patients undergoing nonneurologic and noncardiac surgery.Methods A total of 9285 inpatients aged 65 or above receiving nonneurologic and noncardiac surgery at Peking University People's Hospital from November 2012 to May 2016 were retrospectively recruited to our study.Patients who had suffered PMI were assigned to a myocardial infarction group(MI group)and others were allocated to a nonmyocardial infarction group(non-MI group).Clinical manifestations,comorbidities,preoperative laboratory test results,polypharmacy,characteristics of operation and anesthesia,and prognosis were analyzed and compared between the two groups.A multivariate logistic regression model was built to evaluate risk factors for PMI in aged patients undergoing nonneurologic and noncardiac surgery.Results PMI occurred in 12 patients(0.13％).Previous stroke or transient ischemic attack(TIA) history (OR =159.254,P ＜ 0.001),cardiovascular heart disease (CHD) history (OR=33.645,P ＜0.001),and chronic kidney disease(CKD) (OR =19.393,P =0.003) were independent risk factors for PMI in aged patients undergoing nonneurologic and noncardiac surgery.PMI was associated with longer hospitalization[29 (15 59) days vs.9 (6-15) days,P ＜ 0.001] and higher mortality(58.3 ％).Conclusions Previous stroke or TIA history,CHD history,and CKD are independent risk factors for PMI in aged patients undergoing nonneurologic and noncardiac surgery.The incidence of PMI in patients with these risk factors is not high,but the mortality will be high and hospitalization will be prolonged once PMI occurs.Patients with these characteristics need more careful perioperative care.
