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. 2019 Jan 17;14(1):e0210554.
doi: 10.1371/journal.pone.0210554. eCollection 2019.

Perioperative acute myocardial infarction rate in chronic renal disease patients undergoing orthopedic surgery: Is there any difference between dialyzed and nondialyzed patients?

Thung-Lip Lee  1   2 , Feng-Chen Kao  2   3 , Yao-Chun Hsu  4   5   6 , Ying-Ying Lo  7 , Yuan-Kun Tu  2   3
Affiliations

Perioperative acute myocardial infarction rate in chronic renal disease patients undergoing orthopedic surgery: Is there any difference between dialyzed and nondialyzed patients?

Thung-Lip Lee et al. PLoS One. .

Abstract

Background: The incidence of acute myocardial infarction (AMI) in healthy patients undergoing noncardiac surgery is <1%. When patients with chronic kidney disease (CKD) undergo orthopedic surgery, AMI incidence can be expected to be relatively high. However, data on a population-wide scale is lacking.

Objective: To investigate AMI incidence in patients with CKD (with and without dialysis) undergoing orthopedic surgery.

Design: A population-based study covering the period from January 1, 1997, to December 31, 2011.

Setting: Data from the Taiwan National Health Insurance Research Database.

Participants: Participants were 219,195 patients with CKD who underwent surgery between January 1, 1997, and December 31, 2011.

Results: AMI occurred in 2,708 participants (1.24%). The AMI incidence rate in the dialyzed group was 1.52%, which was higher than that in the nondialyzed group after propensity score matching. Dialysis (odds ratio [OR]: 1.79; 95% confidence interval [CI]: 1.62-1.98), male (OR: 1.42; 95% CI: 1.28-1.57), diabetes mellitus (OR: 1.61; 95% CI: 1.44-1.80), hyperlipidemia (OR: 1.88; 95% CI: 1.68-2.11), old myocardial infarction (OR: 18.87; 95% CI: 16.26-1.21.90), and cerebral vascular disease (CVA) (OR: 1.29; 95% CI: 1.30-1.47) were all associated with AMI in the patients with CKD.

Conclusions: The AMI risk was higher in the patients with CKD undergoing orthopedic surgery than in the general population, and the dialyzed group had a higher risk of AMI than did the nondialyzed group.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. The rate of AMI in all CKD Subjects received surgeries (N = 219195) in 15 years.
AMI (Acute myocardial infarction); CKD (chronic kidney disease).
Fig 2
Fig 2. The rate of AMI in CKD (with/ without dialysis) cases with surgery in 15 years.
AMI (Acute myocardial infarction); CKD (chronic kidney disease); op (operation).
See this image and copyright information in PMC

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