Zhou Xiaoxin, Chen Lingke, Su Zhongxue, Li Yue, Tu Mengyun, Xiao Jie, Pan Zhiying, Su Diansan
Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai.
Department of Anesthesiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Medicine (Baltimore). 2019 Aug;98(34):e16929. doi: 10.1097/MD.0000000000016929.
To examine the characteristics and short-term outcome of perioperative myocardial infarction (PMI), a single-center retrospective study was carried out. The electronic medical records of 278,939 patients aged 45 years or older who underwent non-cardiac surgery at Renji Hospital from January 2003 to December 2015 were screened based on diagnostic codes (ICD121, ICD121.0, ICD121.1, ICD121.2, ICD121.3, ICD121.4, or ICD121.9). The incidence and characteristics of PMI and mortality risk factors were analyzed after non-cardiac surgery. PMI was reported in 45 patients, with an incidence rate of 1.61 per 10,000 and a mortality rate of 75.6% (34/45). The PMI incidence rate increased significantly with age. The PMI incidence rate was the highest for vascular surgery (5.82 per 10,000 cases). PMI occurs mainly within 48 h of surgery, with most cases showing an onset in the general wards. Logistic analysis showed that the use of nitrates is the independent protective factor for the outcomes of patients with PMI. The incidence of PMI in non-cardiac surgery is approximately 2 of 10,000 in patients aged 45 years or older, and increased significantly with age. The use of nitrates might be helpful for their survival.
为研究围手术期心肌梗死（PMI）的特征及短期预后，开展了一项单中心回顾性研究。基于诊断编码（ICD121、ICD121.0、ICD121.1、ICD121.2、ICD121.3、ICD121.4或ICD121.9），筛选了2003年1月至2015年12月在仁济医院接受非心脏手术的278,939例45岁及以上患者的电子病历。分析非心脏手术后PMI的发生率、特征及死亡风险因素。共报告45例PMI，发病率为每10,000例中有1.61例，死亡率为75.6%（34/45）。PMI发病率随年龄显著增加。血管手术的PMI发病率最高（每10,000例中有5.82例）。PMI主要发生在术后48小时内，大多数病例在普通病房发病。Logistic分析显示，使用硝酸盐是PMI患者预后的独立保护因素。45岁及以上患者非心脏手术中PMI的发病率约为每10,000例中有2例，且随年龄显著增加。使用硝酸盐可能有助于其生存。
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