Background: Acute myocardial infarction (AMI) is a major cardiovascular complication of noncardiac surgery. We aimed to evaluate the frequency, causes, and outcomes of 30-day hospital readmission after perioperative AMI.

Methods: Patients who were diagnosed with AMI during hospitalization for major noncardiac surgery were identified using the 2014 US Nationwide Readmission Database. Rates, causes, and costs of 30-day readmissions after noncardiac surgery with and without perioperative AMI were identified.

Results: Among 3 807 357 hospitalizations for major noncardiac surgery, 8085 patients with perioperative AMI were identified. A total of 1135 patients (14.0%) with perioperative AMI died in-hospital during the index admission. Survivors of perioperative AMI were more likely to be readmitted within 30 days than surgical patients without perioperative AMI (19.1% versus 6.5%, P<0.001). The most common indications for 30-day rehospitalization were management of infectious complications (30.0%), cardiovascular complications (25.3%), and bleeding (10.4%). In-hospital mortality during hospital readmission in the first 30 days after perioperative AMI was 11.3%. At 6 months, the risk of death was 17.6% and ≥1 hospital readmission was 36.2%.

Conclusions: Among patients undergoing noncardiac surgery who develop a perioperative MI, ≈1 in 3 suffer from in-hospital death or hospital readmission in the first 30 days after discharge. Strategies to improve outcomes of surgical patients early after perioperative AMI are warranted.

中文翻译：

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与非心脏手术相关的围手术期急性心肌梗死后医院再入院

背景：急性心肌梗塞（AMI）是非心脏手术的主要心血管并发症。我们旨在评估围手术期AMI后30天住院再入院的频率，原因和结果。

方法：使用2014年美国全国再入院数据库，识别出在住院期间因非心脏大手术而被确诊为AMI的患者。确定了有无围手术期AMI的非心脏手术后30天再入院的发生率，原因和费用。

结果：在3807357例非心脏大手术住院患者中，确定了8085例围手术期AMI患者。共有1135例围手术期AMI患者（14.0％）在入院时死亡。与没有围手术期AMI的手术患者相比，围手术期AMI的幸存者在30天之内更有可能再次入院（19.1％对6.5％，P <0.001）。住院治疗30天的最常见指征是感染性并发症（30.0％），心血管并发症（25.3％）和出血（10.4％）的处理。围手术期AMI后头30天内住院再住院期间的院内死亡率为11.3％。在6个月时，死亡风险为17.6％，≥1的住院再入院率为36.2％。

结论：在接受非心脏手术的围手术期MI患者中，约有三分之一的人在出院后的头30天遭受院内死亡或住院再入院。围手术期AMI早期应采取改善手术患者预后的策略。