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[Myocardial ischemia score as a preoperative screening method for intraoperative myocardial ischemia]
T Kaneko1, M Hayashida, Y Saito
1Department of Anesthesiology, Tokyo Metropolitan Futyu Hospital.
Insights
This study identified key risk factors for intraoperative myocardial ischemia in 300 abdominal surgery patients. A myocardial ischemia score (MIS) effectively predicted ischemia, aiding in risk stratification for cardiac events during surgery.
Area of Science:
- Cardiology
- Anesthesiology
- Surgical Risk Assessment
Background:
- Ischemic heart disease (IHD) poses significant risks for patients undergoing abdominal surgery.
- Identifying and quantifying these risks is crucial for patient safety and outcomes.
Purpose of the Study:
- To identify risk factors for intraoperative myocardial ischemia in patients undergoing abdominal surgery.
- To develop and validate a Myocardial Ischemia Score (MIS) for predicting intraoperative myocardial ischemia.
Main Methods:
- A cohort of 300 patients with IHD risk factors undergoing abdominal surgery was studied.
- ST segment monitoring was used to detect intraoperative myocardial ischemia.
- Multiple regression and discriminant analysis were employed to develop the MIS.
Main Results:
- Intraoperative myocardial ischemia occurred in 19.3% of patients.
- The developed MIS demonstrated an 86.3% hitting ratio in predicting myocardial ischemia.
- Higher MIS values correlated with increased risk of intraoperative ischemia.
Conclusions:
- The MIS is a valuable tool for predicting intraoperative myocardial ischemia in surgical patients.
- Early identification and management of patients with high MIS can potentially reduce cardiac events.
- Risk factor assessment and scoring are vital in perioperative cardiac care.
Abstract:
Three hundred patients for abdominal surgery with risk factors of ischemic heart disease (IHD), such as hypertension, diabetes mellitus, hyperlipidemia, smoking, old age, obesity, familial history, electrocardiographic abnormality, other perivascular diseases and male, were included in this study. Patients older than forty years were included in the study. ST segment in lead II and V5 was recorded by ST trend monitor from the time of entering the operating room to the time of exit and intraoperative myocardial ischemia occurred in 58 patients (19.3%). Correlation coefficients between each risk factor of IHD and intraoperative myocardial ischemia were calculated by multiple regression analysis and myocardial ischemia score (MIS) was determined. Intraoperative myocardial ischemia increased in patients with more than 10 points of MIS by discriminant analysis and hitting ratio of MIS was 86.3%.