Myocardial Infarction After Lumbar Surgery: A Critical Meta-Analysis of Cohort versus Database Studies for a Rare Complication

Perez-Roman, Roberto J.; Lu, Victor M.; Govindarajan, Vaidya; Rivera-Babilonia, Jaime M.; Leon-Correa, Roberto; Ortiz-Cartagena, Ismael; Wang, Michael Y.

doi:10.1016/j.wneu.2021.11.086

Cited by 1 publication

(1 citation statement)

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“…Several studies have reported that cardiac complications occur in 0.21%-6.7% of cases following spine surgery [5,[22][23][24]. MI was suggested as a main factor for readmissions within 90 days after spine surgery [25][26][27][28]; thus, even when spine surgery is performed successfully, postoperative management is crucial for patients with underlying IHD.…”

Section: Perioperative Surveillancementioning

confidence: 99%

Management of Patients with Ischemic Heart Disease in Spine Surgery

Song,

Kim,

Song

et al. 2023

Asian Spine J

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In ischemic heart disease (IHD), the myocardium does not receive enough blood and oxygen. Although the IHD-related mortality rate is decreasing, the risk remains and is a major predictor of cardiac complications following noncardiac surgery. Given the increase in the older population, the number of patients with spinal diseases requiring surgery is increasing. Among these patients, those with underlying IHD or a high risk of cardiac complications before and after surgery are also increasing. Given that cardiac complications following spinal surgery are associated with delayed patient recovery and even death, spinal surgeons should be knowledgeable about overall patient management, including medication therapy in those at high risk of developing perioperative cardiac complications for successful patient care. Before surgery, the underlying medical conditions of patients should be evaluated. Patients with a history of myocardial infarction should be checked for a history of surgical treatments, and the anticoagulant dose should be controlled depending on the surgery type. In addition, the functional status of patients must be examined before surgery. Functional status can be assessed according to the metabolic equivalent of task (MET). More preoperative cardiac examinations are needed for patients who are unable to perform four METs in daily because of the high risk of postoperative cardiac complications. Patients with a history of IHD require appropriate preoperative management and further postoperative evaluation. When considering surgery, spinal surgeons should be knowledgeable about patient care before and after surgery.

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