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October 3, 2007

Preoperative Hematocrit Levels and Outcomes After Noncardiac Surgery

JAMA. 2007;298(13):1512-1514. doi:10.1001/jama.298.13.1512-b

To the Editor: The Comment section in the study by Dr Wu and colleagues1 did not discuss the observed association between myocardial infarction (MI) in the 6 months prior to surgery and 30-day postoperative mortality (odds ratio, 2.84; 95% confidence interval, 2.56-3.15). Although MI in the 6 months prior to surgery has been recognized as a risk factor for reinfarction and perioperative mortality,2 it is absent in current guidelines.3 These guidelines define a “recent” MI as having occurred more than 7 days but less than 1 month before surgery, implying that the risk associated with an MI that occurred more than a month prior to surgery is no longer considered to be significant and does not require specific management.

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