Palsson SH, Engstrom C, Enochsson L, Osterlund E, Sandblom G. Risk factors for postoperative myocardial infarct following cholecystectomy: a population-based study.
HPB (Oxford) 2020;
22:34-40. [PMID:
31327561 DOI:
10.1016/j.hpb.2019.06.018]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 05/21/2019] [Accepted: 06/23/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND
The aim was to analyse the risk for myocardial infarction (MI) after cholecystectomy.
METHODS
The study is based on data from the Swedish Register for Gallstone Surgery (GallRiks) 2006-2014. The cohort was cross-linked with the Swedish Patient Register. Standardised incidence ratio (SIR) was calculated by dividing the observed incidence of MI within 30 days after surgery with the expected incidence of the background population.
RESULTS
Altogether 94,577 procedures were included. MI within 30 days postoperatively (30d-po) were registered in 87 cases (0.09%, SIR for MI 3.03; 95% CI 2.43-3.74). MI occurred more often in men (0.15% vs 0.06%), after open surgery (0.34% vs 0.04%), was age related (age >50 years OR 4.05 > 75 years OR 15.70) and occurred more frequently amongst those with gallstone complications and high ASA score (ASA 1; 0.02%, 2; 0.08%, ≥3; 0,64%). The risk for MI within 30d-po was 52.8% if the patient had suffered an infarct within 8 weeks preoperatively. Laparoscopy converted to open and primarily open surgery were independent risk factors (OR 3.05 vs 2.19). The mortality in the group with 30d-po MI was 11.5% vs 0.02%.
CONCLUSION
Delaying elective cholecystectomy for at least 8 weeks after a recent MI reduces the risk for postoperative MI.
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