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Titolo:
Intercurrent drug therapy and perioperative cardiovascular mortality in elective and urgent/emergency surgical patients
Autore:
Sear, JW; Howell, SJ; Sear, YM; Yeates, D; Goldacre, M; Foex, P;
Indirizzi:
Univ Oxford, Nuffield Dept Anaesthet, Oxford OX1 2JD, England Univ OxfordOxford England OX1 2JD pt Anaesthet, Oxford OX1 2JD, England Univ Oxford, Unit Hlth Care Epidemiol, Oxford OX1 2JD, England Univ Oxford Oxford England OX1 2JD re Epidemiol, Oxford OX1 2JD, England
Titolo Testata:
BRITISH JOURNAL OF ANAESTHESIA
fascicolo: 4, volume: 86, anno: 2001,
pagine: 506 - 512
SICI:
0007-0912(200104)86:4<506:IDTAPC>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
NON-CARDIAC SURGERY; MYOCARDIAL-INFARCTION; NONCARDIAC SURGERY; HEART-FAILURE; CALCIUM-ANTAGONISTS; VASCULAR-SURGERY; BETA-BLOCKERS; RISK-FACTORS; ANESTHESIA; ISCHEMIA;
Keywords:
anaesthesia, general; complications, death; complications, cardiovascular disease; anaesthesia, audit; records, anaesthesia; complications, intercurrent drug therapy;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: Sear, JW John Radcliffe Hosp, Nuffield Dept Anaesthet, Oxford OX3 9DU, England John Radcliffe Hosp Oxford England OX3 9DU ord OX3 9DU, England
Citazione:
J.W. Sear et al., "Intercurrent drug therapy and perioperative cardiovascular mortality in elective and urgent/emergency surgical patients", BR J ANAEST, 86(4), 2001, pp. 506-512

Abstract

The Oxford Record Linkage Study (ORLS; an epidemiological database) was used to examine relationships between intercurrent cardiovascular drug therapy and cardiac death within 30 days of elective or emergency/urgent surgery under general anaesthesia. Cases identified from the ORLS were paired with matched control patients. Clinical details were obtained from the patients'medical notes. In elective surgical patients, there was no effect of beta -adrenoceptor or calcium entry channel blockade, diuretics or digoxin on cardiac death after adjusting for confounding variables. Use of nitrates was associated with an odds ratio of 4.79 [95% confidence interval (CI) 1.01-22.72] for cardiac death after adjustment for confounding by a history of angina and residual age difference. In emergency/urgent patients, there were significant univariate associations with cardiac death for intercurrent use of angiotensin converting enzyme (ACE) inhibitors (odds ratio 1.18) and diuretics (odds ratio 4.95; 95% CI 1.82-13.46). However, neither maintained significance after adjustment for the confounding effect of cardiac failure. We conclude that, with the possible exception of the use of nitrates in elective surgical patients, chronic intercurrent drug treatment alone does notsignificantly affect the odds of cardiac death within 30 days of surgery.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 31/03/20 alle ore 22:29:41