To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Myocardial Infarction Increases Mortality Risk in Some Surgical Patients: Presented at ACS URL: http://www.pslgroup.com/dg/22EC0A.htm Doctor's Guide October 14, 2008
By Roberta Friedman, PhD SAN FRANCISCO -- October 14, 2008 -- Different surgical procedures are associated with different levels of mortality risk in patients who have a myocardial infarction (MI) around the time of the procedure, according to data reported here at the American College of Surgeons (ACS) 94th Annual Clinical Congress. Patients who have an MI in the 2 months prior to gall bladder surgery have an increased risk of death, while colon removal was riskier for those who had an MI up to 1 year before surgery, according to data presented on October 13. Researchers analysed database records for all patients in the state who had either colectomy or cholecystectomy from 2000 to 2004. Data were collected for patients whose MI occurred from 1 month to 1 year prior to their surgeries. Mortality in the 30 days after surgery was 5.6% for 145,190 patients who had colectomy. It was 1.4% for the 263,083 patients who had cholecystectomy. The mortality rate was 26% and 19%, respectively, for colectomy patients whose MI occurred 1 or 2 months before surgery compared with 15% for those whose MI occurred more than 2 months prior. These were all significantly increased rates, but for cholecystectomy patients, only MI within 2 months of surgery significantly increased the mortality rate. Investigator Michael Leonardi, MD, Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, and colleagues noted that guidelines recognising the risk of surgery around the time of MI have not been updated to reflect improved perioperative care and less invasive surgeries now available, and that "surgery has risk, but delaying care has risk." "Surgeons may want to consider attempting to delay colectomy and cholecystectomy at least 2 months after an MI," Dr. Leonardi said. The risk for abdominal aortic aneurysm repair, or for amputations, did not appear to be affected by recent MI beyond 1 month, the data showed. Dr. Leonardi acknowledged a weakness of the study was that MI may have been coded when a troponin leak suggested it, but in fact MI may not have occurred. "We don't know how the coders decided" on all MI events recorded in the database used for the research, Dr. Leonardi said. [Presentation title: Operation-Specific Risk of Preoperative Myocardial Infarction. Abstract S76] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.