Risk factors for cardiovascular death within 30 days after anaesthesia andurgent or emergency surgery: a nested case-control study

The Oxford Record Linkage Study (an epidemiological database) was used to i dentify patients who died from a cardiovascular cause within 30 days of eme rgency or urgent surgery under general anaesthesia. Each case was paired wi th a control patient (matched for age within 10 yr of the patient, operatio n and consultant). Additional clinical information was sought from the pati ent's case notes. Cases and controls were compared for cardiovascular risk factors using conditional logistic regression analysis and a prognostic mod el was generated. Only one significant risk factor was identified in the fi nal model: a history of cardiac failure (odds ratio 14.84; 95% confidence i ntervals 2.53-87.13; P=0.003). Associations between a history of cerebrovas cular accident or renal impairment and cardiovascular mortality were seen u sing univariate analysis but not after adjustment for confounding factors.