Risk factors for failure to rescue in myocardial infarction after noncardiac surgery: A cohort study
Anesthesiology Jun 19, 2020
Mazzarello S, McIsaac DI, Beattie WS, et al. - Researchers used the American College of Surgeons (Chicago, Illinois) National Surgical Quality Improvement Program database, to investigate patient as well as surgical risk factors for failure to rescue (ie, mortality after suffering a complication) among patients who have had a perioperative myocardial infarction (a myocardial infarction that happens intraoperatively or within 30 days following surgery). Failure to rescue was encountered by 1,726 (19.3%) of 8,923 (0.68%) people who had a perioperative myocardial infarction. Strongest links (adjusted odds ratio greater than 1.5) were: age 85 yr or older, underweight BMI, American Society of Anesthesiologists class IV and class V, and presence of: ascites, disseminated cancer, systemic inflammatory response syndrome, sepsis, septic shock, and dyspnea at rest. A higher risk of failure to rescue was noted in patients who had emergency surgery, high-risk procedures, and postoperative complications. Overall, findings revealed that risk of failure to rescue following perioperative myocardial infarction was predicted by routinely identified patient and surgical factors.
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