Nettleman M D, Banitt L, Barry W, Awan I, Gordon E E
Virginia Commonwealth University, Richmond 23298-0102, USA.
Am J Med. 1997 Nov;103(5):357-62. doi: 10.1016/s0002-9343(97)00162-9.
To identify risk factors for mortality after postoperative myocardial infarction.
Retrospective study of 266 patients.
The crude in-hospital mortality rate was 25%. This was more than twice as high as the mortality rate in patients admitted from home with 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) and a higher crude mortality rate. Multivariate analysis showed that female gender (relative risk 2.2, 95% confidence limits 1.2 to 4.2), current cigarette smoking (relative risk 2.3 [1.2 to 4.7]), a history of congestive heart failure (relative risk 2.1 [1.04 to 4.1], resuscitation status (relative risk 8.1 [2.0 to 32.9]), and high preoperative APACHE II score were significant independent predictors of in-hospital mortality.
Postoperative myocardial infarction is one of the most serious events a patient can experience. Women and current smokers are at especially high risk for mortality after postoperative myocardial infarction.
确定术后心肌梗死患者死亡的危险因素。
对266例患者进行回顾性研究。
住院总死亡率为25%。这比因急性心肌梗死从家中入院的患者死亡率高出两倍多。术后发生梗死的女性与男性年龄相同，但梗死前急性生理与慢性健康状况评估（APACHE）II评分较低（P = 0.03），且总死亡率较高。多因素分析显示，女性（相对危险度2.2，95%可信区间1.2至4.2）、当前吸烟（相对危险度2.3 [1.2至4.7]）、充血性心力衰竭病史（相对危险度2.1 [1.04至4.1]）、复苏状态（相对危险度8.1 [2.0至32.9]）以及术前APACHE II评分高是住院死亡率的显著独立预测因素。
术后心肌梗死是患者可能经历的最严重事件之一。女性和当前吸烟者术后心肌梗死死亡风险尤其高。
