Risk Factors of Post-Partial Hepatectomy Acute Myocardial Infarction ： A Retrospective Nationwide Inpatient Sample Database Study

Abstract

Background The aftermath of partial hepatectomy often results in a severe condition known as acute myocardial infarction (AMI), which may lead to death and frequently necessitates coronary angiography-directed percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). Despite this, the occurrence and factors associated with AMI following partial hepatectomy have not been comprehensiveky investigated using a nationwide database. Methods This study utilized data from the National Inpatient Sample (NIS) database, covering the years 2015 to 2019, involving 81,735 patients who underwent partial hepatectomy and were categorized into two groups according to the occurrence of AMI. Patient demographics (age, sex, and race), hospital characteristics (type of admission and payer, and bed size, teaching status, and location), length of stay (LOS), total charges during hospitalization, in-hospital mortality, comorbidities, and perioperative complications were analyzed. A multivariate logistic regression analysis was conducted to ascertain independent predictors of acute myocardial infarction following partial hepatectomy. Results A total of 81,735 partial hepatectomies was identified from the National Inpatient Sample, with an overall incidence of in-hospital AMI post partial hepatectomy of 0.8%. Except for 2015, the annual incidence rate of AMI exhibited a downward trend from 2016 to 2019. Patients with AMI after partial hepatectomy were associated with prolonged hospitalization, overall expenses, usage of Medicare, and in-hospital mortality. Factors associated with AMI comprised advanced age (≥ 80 years), multiple comorbidities (n ≥ 6), coronary heart disease, congestive heart failure, coagulopathy, fluid and electrolyte disorders, neurological disorders and paralysis. Furthermore, AMI was associated with cardiac arrest, respiratory failure, acute renal failure, pulmonary embolism, stroke, gastrointestinal hemorrhage, thrombocytopenia, and pneumonia. Conclusion The present study revealed a relatively low occurrence of in-hospital AMI following partial hepatectomy, coupled with unfavorable outcomes. Exploring the risk factors associated with AMI post-partial hepatectomy is essential for optimal treatment and mitigating potential adverse outcomes. Trial registration retrospectively registered