A 50yo pt is admitted for elective herniorraphy. Which of the following options will lead to a postponement of the operation?
a. SBP 110mmHg
b. MI 2 months ago
c. Hgb 12g/dl
d. Pain around hernia
e. Abdominal distention
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answer: B
Data which suggest waiting 6 months post-MI for elective surgery are
based on several enormous (> 40,000 patients), one of which was at
the Mayo Clinic, and most of which show a reduction in mortality when
waiting 6 months after an MI. Note that these are in the pre-B-blocker
era, however there are currently no better data refuting these findings
It is thought that recovery following myocardial infarction takes ~ 6
weeks. That said, studies from 1977-1990, when taken in aggregate,
suggest that one should postpone elective surgery 6 months following a
myocardial infarction.
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