RISK-FACTORS IN PATIENTS UNDERGOING MAJOR NONVASCULAR ABDOMINAL OPERATIONS THAT PREDICT PERIOPERATIVE MYOCARDIAL-INFARCTION

BACKGROUND: Perioperative myocardial infarction (PMI) is an uncommon b ut serious complication of major abdominal surgery. Identifying the pa tients at risk may potentially reduce morbidity and mortality. In this study we determined risk factors associated with PMI in patients unde rgoing 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 opera tion. 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 4 1% mortality rate (14 of 34). Risk factors for PMI included poor gener al condition, congestive heart failure, abnormal cardiac rhythm, smoki ng, previous myocardial infarction (MI), and emergent operation. CONCL USION: Although PMI following ANVS is uncommon, the mortality rate rem ains high. Patients classified as Goldman's class III and IV, or with a history of cigarette smoking, previous MI, or angina merit further e valuation in order to reduce the incidence of this complication. (C) 1 997 by Excerpta Medica, Inc.