Risk factors associated with myocardial injury after non-cardiac major surgery in ICU admitted patients

Shu Li, F. Zhu, F. Guo, Lilei Jiang, Haiyan Xue, Xiujuan Zhao, Y. An
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Abstract

Objective To analyze the risk factors related to the myocardial injury after non-cardiac surgery (MINS) in patients who underwent major abdominal surgery. Methods The clinical data of all patients admitted in the surgical ICU of Peking University People′s Hospital from Jan 2016 to Dec 2018 were analyzed. Logistic multivariate analysis was performed to analyze the association of clinical characteristics with the incidence of MINS. Results A total of 322 patients were included, 48.4% (156/322) were diagnosed as with MINS. 97.4% (152/156) of MINS occurred during the first 72 h of admission. Multivariate analysis showed that independent predictive factors of MINS were age >65y (OR=1.747, P=0.021), body mass index (OR=1.085, P=0.008), acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ, OR=1.066; P=0.047), hypertension (OR=1.747, P=0.027), blood lactate (OR=1.393, P=0.001) and acute kidney injury (OR=2.065, P=0.047). Conclusions The incidence of MINS in patients who underwent major abdominal surgery was high. Age, body mass index, APACHE Ⅱ score, hypertension, blood lactate level and acute kidney injury after surgery were independent risk factors of MINS. Key words: Postoperative complications; Intensive care; Risk factors; Myocardial injury
ICU住院患者非心脏大手术后心肌损伤的相关危险因素
目的分析腹部大手术患者非心脏手术后心肌损伤的相关危险因素。方法对2016年1月至2018年12月北京大学人民医院外科ICU收治的所有患者的临床资料进行分析。采用Logistic多因素分析分析临床特征与MINS发病率的关系。结果共纳入322例患者,其中48.4%(156/322)诊断为MINS。97.4%(152/156)的MINS发生在入院前72小时。多因素分析显示,min的独立预测因素为年龄(OR=1.747, P=0.021)、体重指数(OR=1.085, P=0.008)、急性生理和慢性健康评价Ⅱ(APACHEⅡ,OR=1.066;P=0.047)、高血压(OR=1.747, P=0.027)、血乳酸(OR=1.393, P=0.001)、急性肾损伤(OR=2.065, P=0.047)。结论腹部大手术患者的MINS发生率较高。年龄、体重指数、APACHEⅡ评分、高血压、血乳酸水平、术后急性肾损伤是MINS的独立危险因素。关键词:术后并发症;重症监护;风险因素;心肌损伤
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