MYOCARDIAAL INFARCTION AND SURGERY a five year study

Topkins, Marjorie J.; Artusio, Joseph F.

doi:10.1213/00000539-196411000-00022

Cited by 111 publications

(23 citation statements)

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“…The poor long-term prognosis in nonsurgical patients with cardiac disorders, renal and hepatic insufficiency, strokes, senile dementia, and diabetes has been adequately documented in literature [Bjornberg, I960;Block et al, 1952;Frank, 1968;Joslin, 1959;Marquardsen, 1969;Norris, 1959;Ostrander, 1970; Andkrsen/ 0 stbf.rg Duration of observation, years Robinson et al, 1961;Roth, 1955;Sievers, 1964] and their influence on surgical risk likewise [Andersen et al, 1965;Bock, 1959: BoRTzand Bortz, 1955Claes et al, 1966;Etsten and Proger, 1955;Grivaux and Barraine, 1965;Hanger and Hall, 1963;Irmer, 1957;Lindenmuth and Eisenberc., 1963;Meissner, 1959;Nachlas et al, 1961;Powers, 1968;Skinner and Pearce, 1964;Topkins and Artusio, 1964;Vinz and Jahn, 1968]. The evidently good prognosis in obesity according to this study is in contrast to findings by others [H/EGER and Hall, 1963;Hegemann, 1959].…”

Section: Discussioncontrasting

confidence: 48%

Survival Rates in Surgery of the Aged

Andersen¹,

Ostberg²

1972

Geront clin

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Estimated survival rates in a series of 7,922 operated elderly patients with a 2- to 17-year follow-up indicate that long-term prognosis in geriatric surgery as well as immediate prognosis are to a large extent determined by the frequent coexisting diseases and morbid conditions. Some of these, i.e. hepatic diseases, strokes, senile dementia, severe cardiac disease, renal insufficiency, and diabetes carry an obvious excess mortality, while patients with obesity and arterial hypertension have survival experience equal to that of a Danish population comparable with regard to period, age, and sex.

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Section: Discussioncontrasting

confidence: 48%

Survival Rates in Surgery of the Aged

Andersen¹,

Ostberg²

1972

Geront clin

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“…12,13 Consequently, physicians searched for clinical indicators which might predict the risk for developing cardiac complications during the perioperative period. 15,16 In 1977, Goldman et al published their landmark article on cardiac risk index (CRI), based on the summation of several risk factors and the relative weight of each. 17 The CRI was used to quantify the potential for having perioperative cardiac complications.…”

Section: Historymentioning

confidence: 99%

ACC/AHA guidelines for preoperative cardiovascular evaluation for noncardiac surgery: A critical point of view

Barák

Ben‐Abraham

Katz

2006

Clinical Cardiology

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Summary: This review examines the issue of preoperative cardiac evaluation from a critical point of view, based on recent medical literature. We reviewed the history of that field and focused on the American College of Cardiology and American Heart Association guidelines, which are a cornerstone in the field of cardiac patients undergoing noncardiac surgery. These guidelines synthesized the data into a comprehensive format and established the concept of integrating the patient's risk with the surgical risk. Nevertheless, there are some weaknesses in the guidelines. We believe that a better understanding of the guideline limitations will allow an improved and more educated practice of its recommendations.

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“…Patients with no prior history of MI have low risk of perioperative MI (0.1-0.6%), those with a history of prior MI are at a significantly higher risk (2.8-7) [4][5][6][7] with highest risk in patients with MI within 3 months of non-cardiac surgery [6]. The majority of perioperative MI are known to occur in the first 3 days after surgery with peak incidence on day 2 [5,7].…”

Section: Risk Of Perioperative Cardiac Events During Non-cardiac Surgerymentioning

confidence: 99%

“…The lack of classic symptoms of chest pain, but rather an atypical presentation with new onset congestive heart failure, hypotension, arrhythmias, nausea or altered mental status make the clinical diagnosis challenging. Perioperative MI is associated with high mortality ranging from 26-70% [1][2][3][4][5][6][7]. Therefore, it is imperative to identify patients who are at risk for untoward outcomes after surgery by using a systematic stepwise strategic preoperative evaluation such as that put forward in the guidelines of the ACC/AHA task force [8][9][10][11].…”

Section: Risk Of Perioperative Cardiac Events During Non-cardiac Surgerymentioning

confidence: 99%

Noncardiac Surgery: Evaluating and Minimizing Cardiac Risk

Mehta¹,

Sketch²,

Bossone³

et al. 2005

CCR

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Perioperative cardiac complications remain a great concern during noncardiac surgeries since a large majority of patients undergoing such procedures are elderly, who have a greater prevalence of coronary artery disease. Thus, it is imperative to assess risk of perioperative cardiac complications in all patients scheduled for noncardiac surgery. The current review attempts to outline a systematic approach to assess cardiac risk for noncardiac surgery and suggest strategies to minimize these risks. This approach uses a combination of the urgency of noncardiac surgery, interval since prior revascularization to noncardiac surgery, the interval between prior evaluation of coronary artery disease, patients clinical risks for cardiac complications, and patients functional status to decide their perioperative cardiac risks. If surgery is urgent or the estimated risk for perioperative event is low, then irrespective of the risk, patients should proceed with noncardiac surgery under the influence of appropriate medical strategy to minimize risk. If patients risk of perioperative events is high, then postponing or canceling surgery and referral for invasive approach to identify and when appropriate revascularize coronary artery disease may help reduce the perioperative cardiac risk. In contrast, patients at intermediate risk for perioperative events may benefit from noninvasive assessment for coronary artery disease and referral for appropriate patients for coronary revascularization based on the results of such noninvasive testing. Medical perioperative strategy that should be part of all patients undergoing noncardiac surgery who have or are at risk for coronary artery disease, should include betablockers, adequate analgesia, monitoring fluid status, and maintaining hematocrit >30 gm/dl. Finally, the physician-patient interaction during the hospitalization during noncardiac surgery should be recognized as an important opportunity to institute secondary prevention strategies for coronary artery disease in patients at risk for coronary atherosclerosis.

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MYOCARDIAAL INFARCTION AND SURGERY a five year study

Cited by 111 publications

References 0 publications

Survival Rates in Surgery of the Aged

Survival Rates in Surgery of the Aged

ACC/AHA guidelines for preoperative cardiovascular evaluation for noncardiac surgery: A critical point of view

Noncardiac Surgery: Evaluating and Minimizing Cardiac Risk

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