CBS 2019
CBSMD教育中心
English

科学研究

科研文章

荐读文献

Randomized comparison of stent strut coverage following angiography- or optical coherence tomography-guided percutaneous coronary intervention Restenosis, Stent Thrombosis, and Bleeding Complications - Navigating Between Scylla and Charybdis Impact of Oxidative Stress on the Heart and Vasculature: Part 2 of a 3-Part Series Translational Perspective on Epigenetics in Cardiovascular Disease Coronary Artery Calcium Progression Is Associated With Coronary Plaque Volume Progression - Results From a Quantitative Semiautomated Coronary Artery Plaque Analysis Spontaneous Coronary Artery Dissection: JACC State-of-the-Art Review Impact of Abnormal Coronary Reactivity on Long-Term Clinical Outcomes in Women New AHA/ACC/HRS Guidance on Sudden Cardiac Death Prevention Complete Revascularization During Primary Percutaneous Coronary Intervention Reduces Death and Myocardial Infarction in Patients With Multivessel Disease-Meta-Analysis and Meta-Regression of Randomized Trials Patient Characteristics Associated With Antianginal Medication Escalation and De-Escalation Following Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From the OPEN CTO Registry

Clinical Trial2018 May 29;137(22):2332-2339.

JOURNAL:Circulation. Article Link

Hospital Readmission After Perioperative Acute Myocardial Infarction Associated With Noncardiac Surgery

Smilowitz NR, Beckman JA, Sherman SE et al. Keywords: acute coronary syndrome; hospital readmission; myocardial infarction; noncardiac surgery; perioperative; readmission; surgery

ABSTRACT


BACKGROUND - Acute myocardial infarction (AMI) is a major cardiovascular complication of noncardiac surgery. We aimed to evaluate the frequency, causes, and outcomes of 30-day hospital readmission after perioperative AMI.


METHODS - Patients who were diagnosed with AMI during hospitalization for major noncardiac surgery were identified using the 2014 US Nationwide Readmission Database. Rates, causes, and costs of 30-day readmissions after noncardiac surgery with and without perioperative AMI were identified.

RESULTS - Among 3 807 357 hospitalizations for major noncardiac surgery, 8085 patients with perioperative AMI were identified. A total of 1135 patients (14.0%) with perioperative AMI died in-hospital during the index admission. Survivors of perioperative AMI were more likely to be readmitted within 30 days than surgical patients without perioperative AMI (19.1% versus 6.5%, P<0.001). The most common indications for 30-day rehospitalization were management of infectious complications (30.0%), cardiovascular complications (25.3%), and bleeding (10.4%). In-hospital mortality during hospital readmission in the first 30 days after perioperative AMI was 11.3%. At 6 months, the risk of death was 17.6% and ≥1 hospital readmission was 36.2%.

CONCLUSIONS - Among patients undergoing noncardiac surgery who develop a perioperative MI, ≈1 in 3 suffer from in-hospital death or hospital readmission in the first 30 days after discharge. Strategies to improve outcomes of surgical patients early after perioperative AMI are warranted.

© 2018 American Heart Association, Inc.