BACKGROUND The aim was to analyse the risk for myocardial infarction (MI) after cholecystectomy. METHODS The study is based on data from the Swedish Register for Gallstone Surgery (GallRiks) 2006-2014. The cohort was cross-linked with the Swedish Patient Register. Standardised incidence ratio (SIR) was calculated by dividing the observed incidence of MI within 30 days after surgery with the expected incidence of the background population. RESULTS Altogether 94,577 procedures were included. MI within 30 days postoperatively (30d-po) were registered in 87 cases (0.09%, SIR for MI 3.03; 95% CI 2.43-3.74). MI occurred more often in men (0.15% vs 0.06%), after open surgery (0.34% vs 0.04%), was age related (age >50 years OR 4.05 > 75 years OR 15.70) and occurred more frequently amongst those with gallstone complications and high ASA score (ASA 1; 0.02%, 2; 0.08%, ≥3; 0,64%). The risk for MI within 30d-po was 52.8% if the patient had suffered an infarct within 8 weeks preoperatively. Laparoscopy converted to open and primarily open surgery were independent risk factors (OR 3.05 vs 2.19). The mortality in the group with 30d-po MI was 11.5% vs 0.02%. CONCLUSION Delaying elective cholecystectomy for at least 8 weeks after a recent MI reduces the risk for postoperative MI.

中文翻译：

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胆囊切除术后心肌梗死的危险因素：一项基于人群的研究。

背景技术的目的是分析胆囊切除术后心肌梗死（MI）的风险。方法该研究基于瑞典胆结石外科注册（GallRiks）2006-2014年的数据。该队列与瑞典患者注册系统进行了交叉链接。通过将术后30天内观察到的MI发生率除以背景人群的预期发生率，来计算标准发生率（SIR）。结果总共包括94,577例程序。术后30天内（30d-po）发生MI的病例为87例（0.09％，MI的SIR为3.03； 95％的CI为2.43-3.74）。在开放手术后，MI的发生率更高，男性（0.15％vs 0.06％），与年龄相关（年龄> 50岁或4.05> 75岁或15岁）（0.34％vs 0.04％）。70），并在胆结石并发症和高ASA评分的患者中更频繁发生（ASA 1; 0.02％，2; 0.08％，≥3; 0,64％）。如果患者在术前8周内发生梗塞，则30d-po内发生MI的风险为52.8％。腹腔镜手术转为开腹手术和初次开腹手术是独立的危险因素（OR 3.05 vs 2.19）。30d-po MI组的死亡率为11.5％，而0.02％。结论近期发生心梗后将择期胆囊切除术延迟至少8周可降低术后发生心梗的风险。