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The predictive value of serial acute physiology score (APS) and simplified acute physiology score II (SAPS II) in post-operative liver transplant patients

Authors
Journal
Critical Care
1364-8535
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Volume
4
Identifiers
DOI: 10.1186/cc959
Keywords
  • Meeting Abstract
Disciplines
  • Biology
  • Medicine

Abstract

abstracts.qxd http://ccforum.com/supplements/4/S1 P1 Work up to rule out perioperative myocardial infarction: is it overused? SK Appavu, TR Haley, A Khorasani and SR Patel Departments of Surgery and Anesthesiology, Cook County Hospital and the Department of Surgery, University of Illinois College of Medicine, Chicago, Illinois, USA The awareness of the diagnostic difficulty and the docu- mented high mortality risk of perioperative myocardial infarction (PMI) has led to the wide use of work up to rule out PMI after major noncardiac operations. This has caused stable postoperative patients to be kept in moni- tored hospital beds for extended periods of time and to be subjected to additional tests. We hypothesized that the mortality of PMI is high and, therefore, the wide use of postoperative work up to identify these patients is jus- tifiable. We performed the following study to prove our hypothesis. All patients in the recovery room after major noncardiac operations who underwent work up to rule out PMI were identified and followed. The PMI work up included care in an electronically monitored unit, physical assessment, continuous ECG monitoring, and three 12- lead electrocardiograms and cardiac enzymes obtained at six to eight hour intervals. Data collection included patient demographics; preoperative cardiac risk factors; incidence of intraoperative hypotension, hemorrhage and ECG changes; type of anesthesia and operative proce- dures and their durations; postoperative ECG and cardiac enzyme results; the incidence of PMI and patient outcome. Two hundred patients were studied; 85 males and 115 females. Their mean age was 62.9 years. Preexisting con- ditions included hypertension in 162 patients, peripheral arterial disease in 102, diabetes mellitus in 97, angina in 30, previous myocardial infarction in 41, and smoking in 107. Of 200 patients, 164 had an abnormal preoperative ECG. Vascular operations were performed in 104 patients, nonvascular abdominal operations in 48, and other operati

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