Operative factors and the long-term incidence of acute myocardial infarction after transurethral resection of the prostate

被引：19

作者：

Hahn, RG ^{[1
]}

Nilsson, A ^{[1
]}

Farahmand, BY ^{[1
]}

Ekengren, J ^{[1
]}

Persson, PG ^{[1
]}

机构：

[1] STOCKHOLM S HOSP,DEPT ANESTHESIA,STOCKHOLM,SWEDEN

来源：

EPIDEMIOLOGY | 1996年 / 7卷 / 01期

关键词：

cohort study; irrigation; complications; myocardial infarction; prostate surgery;

D O I：

10.1097/00001648-199601000-00016

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

We studied the association between the operative course of transurethral resection of the prostate (TURP) and the morbidity of acute myocardial infarction (AMI) in a cohort comprising 846 patients who underwent this operation between 1983 and 1992. Up to the end of 1993, a total of 69 patients had developed AMI, of which 10 patients had a reinfarction. The relative risk associated with absorption of 500 ml or more of the irrigating medium during surgery was 1.6 [95% confidence interval (CI) = 0.9-3.0] for a first-time AMI after TURP, 6.1 (95% CI = 1.8-20.7) for a reinfarction, and 2.2 (95% CI = 1.3-3.9) for a first-time or a reinfarction combined. A blood loss of 275 ml or more was associated with a decreased relative risk (RR = 0.4; 95% CI = 0.2-0.8) of a first-time AMI after TURP. Patients who lost less than 275 ml of blood and absorbed 500 ml or more of irrigating fluid during surgery had 4.4 times the risk of having an acute myocardial infarction (RR = 4.4; 95% CI = 1.7-11.8). These results appear to indicate that the operative course of TURF is important to the development of AMI over an extended period of time.

引用

页码：93 / 95

页数：3

共 17 条

[1]

Roos N.P., Wennberg J.E., Malenka D.J., Fisher E.S., McPherson K., Andersen T.F., Cohen M.M., Ramsey E., Mortality and reoperation after open and tran-surethral resection of the prostate for benign prostatic hyperplasia, N Engl J Med, 320, pp. 1120-1124, (1989)

[2]

Malenka D.J., Roos N., Fisher E.S., McLerran D., Whaley F.S., Barry M.J., Bruskewitz R., Wennberg J.E., Further study of the increased mortality following transurethral prostatectomy: A chart-based analysis, J Urol, 144, pp. 224-228, (1990)

[3]

Hargreave T.B., Heyns C.F., Kendrick S.W., Whyte B., Black R.J., Clarke J.A., Reoperation and mortality after transurethral and open prostatectomy in Scotland, British Association of Urologists Annual Meeting, (1992)

[4]

Hooten M.E., Finstuen K., Thompson I.M., Multivariate case-control study of survival following transurethral resection of the prostate, Urology, 39, pp. 111-116, (1992)

[5]

Sidney S., Quesenberry C.P., Sadler M.C., Cattolica E.V., Lydick E.G., Guess H.A., Reoperation and mortality after surgical treatment of benign prostatic hypertrophy in a large prepaid medical care program, Med Care, 30, pp. 117-125, (1992)

[6]

Taylor Z., Krakauer H., Mortality and reoperation following prostatectomy: Outcomes in a Medicare population, Urology, 38, pp. 27-30, (1991)

[7]

Hahn R.G., Berlin T., Lewenhaupt A., Irrigating fluid absorption and blood loss during transurethral resection of the prostate studied by a regular interval monitoring (RIM) method, Scand J Urol Nephrol, 22, pp. 23-30, (1988)

[8]

Hahn R.G., Calculation of irrigant absorption by measurement of breath alcohol level during transurethral resection of the prostate, Br J Urol, 68, pp. 390-393, (1991)

[9]

Stalberg H.P., Hahn R.G., Jones A.W., Ethanol monitoring of transurethral prostatic resection during inhalation anesthesia, Anesth Analg, 75, pp. 983-988, (1992)

[10]

Hahn R.G., Ekengren J., Patterns of irrigating fluid absorption during transurethral resection of the prostate as indicated by ethanol, J Urol, 149, pp. 502-506, (1993)

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