Does the presence of coronary artery disease increase postoperative mortality in surgical patients?
Patients with coronary artery disease undergoing surgery face a high postoperative mortality rate, particularly those with a recent preoperative myocardial infarction.
A two-month postoperative follow-up of 1,005 patients with coronary artery disease demonstrated that 225 patients, or 22.3%, died. This mortality was twice that of surgical patients in similar circumstances but without specific diagnosis of coronary artery disease. Among 27 patients who had suffered a preoperative myocardial infarction, less than three months before surgery, 11 died; this mortality of 40% was higher than the overall rate. The type of infarction was found to be significant, with a much lower mortality following subendocardial lesions as compared to transmural infarctions. Postoperative myocardial infarction was observed in 55 cases and resulted in 38 deaths, a mortality of 69%. Comparison of the various agents and methods used for anesthesia failed to show a significant difference.
Arkins et al. (Mon,) studied this question.
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