Qi-Wen Deng1, Wen-Cheng Tan2, Bing-Cheng Zhao3, Wen-Tao Deng4, Miao Xu5, Wei-Feng Liu6, Ke-Xuan Liu7. 1. Department of Anesthesiology, Nanfang Hospital, Southern Medical University, No. 1838, Guangzhou Avenue North, Guangzhou 510515, China; Department of Anesthesiology, The First Affiliated Hospital, Sun Yet-sen University, No.58, Zhongshan 2nd Road, Guangzhou 510080, China. Electronic address: dengqiwen0315@163.com. 2. Department of Endoscopy, Sun Yet-sen University Cancer Center, No. 651, Dongfeng East Road, Guangzhou 510060, China. Electronic address: tanwch@sysucc.org.cn. 3. Department of Anesthesiology, Nanfang Hospital, Southern Medical University, No. 1838, Guangzhou Avenue North, Guangzhou 510515, China. Electronic address: zhaobch@mail2.sysu.edu.cn. 4. Department of Anesthesiology, Nanfang Hospital, Southern Medical University, No. 1838, Guangzhou Avenue North, Guangzhou 510515, China. Electronic address: 965873130@qq.com. 5. Department of Anesthesiology, The First Affiliated Hospital, Sun Yet-sen University, No.58, Zhongshan 2nd Road, Guangzhou 510080, China. Electronic address: spring_xum@163.com. 6. Department of Anesthesiology, Nanfang Hospital, Southern Medical University, No. 1838, Guangzhou Avenue North, Guangzhou 510515, China. Electronic address: sglwfeng01@21cn.com. 7. Department of Anesthesiology, Nanfang Hospital, Southern Medical University, No. 1838, Guangzhou Avenue North, Guangzhou 510515, China. Electronic address: liukexuan507@163.com.
Abstract
PURPOSE: We aimed to seek risk factors for AMI among adult patients undergoing cardiac surgery. MATERIALS AND METHODS: We searched electronic bibliographic databases for studies reporting risk factors for AMI among adult patients undergoing cardiac surgery. Pooled odds ratios (OR) and standard mean differences (SMD or MD) for risk factors between AMI and control group were estimated. RESULTS: 11 studies with 67,195 patients met the inclusion criteria. 14 risk factors were found to be statistically significant: preoperative factors including age (MD 4.62years, 95% CI (1.97,7.27)), cardiac shock (OR 5.17, (1.17,22.81)), peripheral vascular disease (OR 3.53, (2.05,6.09)), need for intra-aortic balloon pump (IABP) (OR 5.89, (3.26,10.65)), emergency surgery (OR 3.75, (1.69,8.33)), and postoperative factors including atrial fibrillation (OR 2.41, (1.79,3.24)), CK-MB level (SMD 1.06, (0.62 to 1.50)), serum creatinine >200μmol/L (OR 23.39, (11.61,47.12)), blood loss (MD 358.32mL, (53.56,663.07)), prolonged ventilation (OR 9.04, (5.24,15.62)), need for IABP (OR 6.32, (3.19,12.54)), inotropic treatment (OR 8.40, (3.19,22.14)), blood transfusion (OR 9.15, (4.79,17.48)), reoperation (OR 3.30, (1.55,7.04)). CONCLUSIONS: 14 risk factors were associated with an increased risk of AMI, which indicated that AMI might occur via stenosis or occlusion of mesenteric vessels, reduced blood volume or maldistribution of blood flow.
PURPOSE: We aimed to seek risk factors for AMI among adult patients undergoing cardiac surgery. MATERIALS AND METHODS: We searched electronic bibliographic databases for studies reporting risk factors for AMI among adult patients undergoing cardiac surgery. Pooled odds ratios (OR) and standard mean differences (SMD or MD) for risk factors between AMI and control group were estimated. RESULTS: 11 studies with 67,195 patients met the inclusion criteria. 14 risk factors were found to be statistically significant: preoperative factors including age (MD 4.62years, 95% CI (1.97,7.27)), cardiac shock (OR 5.17, (1.17,22.81)), peripheral vascular disease (OR 3.53, (2.05,6.09)), need for intra-aortic balloon pump (IABP) (OR 5.89, (3.26,10.65)), emergency surgery (OR 3.75, (1.69,8.33)), and postoperative factors including atrial fibrillation (OR 2.41, (1.79,3.24)), CK-MB level (SMD 1.06, (0.62 to 1.50)), serum creatinine >200μmol/L (OR 23.39, (11.61,47.12)), blood loss (MD 358.32mL, (53.56,663.07)), prolonged ventilation (OR 9.04, (5.24,15.62)), need for IABP (OR 6.32, (3.19,12.54)), inotropic treatment (OR 8.40, (3.19,22.14)), blood transfusion (OR 9.15, (4.79,17.48)), reoperation (OR 3.30, (1.55,7.04)). CONCLUSIONS: 14 risk factors were associated with an increased risk of AMI, which indicated that AMI might occur via stenosis or occlusion of mesenteric vessels, reduced blood volume or maldistribution of blood flow.
Authors: I Djordjevic; K Eghbalzadeh; S Heinen; G Schlachtenberger; S Gerfer; A Sabashnikov; J Merkle; C Weber; E Kuhn; M Zeriouh; P Rahmanian; N Mader; O-J Liakopoulos; T Wahlers Journal: World J Surg Date: 2020-01 Impact factor: 3.352