Abstract 1107: Risk Factors Predicting Intra and Postoperative Cardiac Arrest or Myocardial Infarction in Surgical Patients
Objective: To identify factors associated with intra and postoperative myocardial infarction or cardiac arrest (MICA) within 30 days of surgery.
Methods: Multivariate logistic regression of the American College of Surgeons’ 2007 National Surgical Quality Improvement Program (NSQIP) data. 203,836 patients of this multicenter, prospective dataset were studied.
Results: MICA was seen in 1,248 patients (0.61%). 30-day mortality was higher in patients who developed MICA than those who did not (61.42% vs. 1.35%, p<0.0001). Preoperative risk factors which predict MICA are mentioned in the table⇓. In comparison to a group of surgeries with low incidence of MICA (anorectal, bariatric, breast, gallbladder, appendix, adrenal, spleen, ENT/neck, obstetric/gynecologic, hernia, spine, skin, urologic and vein surgeries), higher rates of MICA occurred after aortic (OR 2.9 CI-2.3–3.8), esophageal, stomach, pancreas, duodenum, liver and bile duct (OR 2.5 CI-2.0 –3.1), intestinal (OR 1.8 CI-1.5–2.2), brain (OR 3.0 CI-1.4 – 6.6), other abdominal (OR 1.6 CI-1.1–2.2), and other vascular surgeries (OR 1.3 CI-1.1–1.6). There was not a higher risk with cardiac, orthopedic and thoracic surgeries.
Conclusions: MICA - while uncommon - is associated with increased 30- day mortality. Variables associated with increased risk of MICA include factors related to age, gender, race, comorbidity, functional status and the type of surgery.