PREDICTORS OF SURVIVAL AND THE ROLE OF GENDER IN POSTOPERATIVE MYOCARDIAL-INFARCTION

PURPOSE: To identify risk factors for mortality after postoperative my ocardial infarction. METHOD: Retrospective study of 266 patients. RESU LTS: The crude in-hospital mortality rate was 25%. This was more than twice as high as the mortality rate in patients admitted from home wit h an acute myocardial infarction. Women with postoperative infarction were the same age as men, but had a lower Acute Physiology and Chronic Health Evaluation (APACHE) II score prior to infarction (P = 0.03) an d a higher crude mortality rate. Multivariate analysis showed that fem ale gender (relative risk 2.2, 95% confidence limits 1.2 to 4.2), curr ent cigarette smoking (relative risk 2.3 [1.2 to 4.7]), a history of c ongestive heart failure (relative risk 2.1 [1.04 to 4.1], resuscitatio n status (relative risk 8.1 [2.0 to 32.9]), and high preoperative APAC HE II score were significant independent predictors of in-hospital mor tality. CONCLUSION: Postoperative myocardial infarction is one of the most serious events a patient can experience. Women and current smoker s are at especially high risk for mortality after postoperative myocar dial infarction. (C) 1997 by Excerpta Medica, Inc.