Dirksen A, Kjøller E
Department of Internal Medicine, Central Hospital, Hillerød, Denmark.
BMJ. 1988 Oct 22;297(6655):1011-3. doi: 10.1136/bmj.297.6655.1011.
Cardiac risk factors were studied among patients who were admitted to hospital with appendicitis or a fracture of the proximal femur less than one year after being admitted with myocardial infarction. Of 99 patients with myocardial infarction and appendicitis, 87 underwent appendicectomy; and of 221 with myocardial infarction and hip fracture, 179 were operated on. The patients were studied on an intention to treat basis. The mortality within one month was 9% and 16% respectively. A history of congestive heart failure was the dominating risk factor, while ischaemic heart disease (recent myocardial infarction or angina pectoris) had no independent association with mortality. If the ventricular function is known additional preoperative information about the heart is of negligible value when estimating the mortality of non-cardiac surgery.
在因心肌梗死入院不到一年后又因阑尾炎或股骨近端骨折入院的患者中研究了心脏危险因素。在99例患有心肌梗死和阑尾炎的患者中,87例接受了阑尾切除术;在221例患有心肌梗死和髋部骨折的患者中,179例接受了手术。对患者按意向性治疗原则进行研究。一个月内的死亡率分别为9%和16%。充血性心力衰竭病史是主要的危险因素,而缺血性心脏病(近期心肌梗死或心绞痛)与死亡率无独立关联。如果已知心室功能,在估计非心脏手术的死亡率时,关于心脏的额外术前信息价值可忽略不计。