Joan Rivers, the raucous, acid-tongued comedian who crashed the male-dominated realm of late-night talk shows and turned Hollywood red carpets into danger zones for badly dressed celebrities, died Thursday. She was 81.

Rivers died at Mount Sinai Hospital in New York, surrounded by family and close friends, daughter Melissa Rivers said. She was hospitalized Aug. 28 after going into cardiac arrest in a doctor's office following a routine procedure. The New York state health department is investigating the circumstances surrounding Rivers' cardiac arrest during an outpatient procedure.

"My mother's greatest joy in life was to make people laugh," Melissa Rivers said. "Although that is difficult to do right now, I know her final wish would be that we return to laughing soon."

Under the immobile, plastic surgery-crafted veneer that became Joan Rivers' unapologetic trademark as she aged, her wit remained as vibrantly raw and unruly as when she first broke her way into a comedy world belonging largely to men.

Fashion and acting were the early dreams of the woman who grew up as a self-described "fatty," but it was humor that paid the bills and ultimately made Rivers a star. She refused to cede the spotlight as the decades passed, working vigorously until her death.

"I have never wanted to be a day less than I am," she said in a 2013 interview with The Associated Press. "People say, 'I wish I were 30 again.' Nahhh! I'm very happy HERE. It's great. It gets better and better. And then, of course, we die," she quipped.

Rivers was a scrapper, rebuilding her career and life after a failed attempt to make it as a late-night host was followed closely by her husband's suicide.

Rivers' style was hard-driving from the start and her material only got sharper. She was ready to slam anyone. A favored target was Elizabeth Taylor's weight ("her favorite food is seconds"), but the comedian kept current with verbal assaults on Miley Cyrus and other newcomers.

With her raspy voice and brash New York accent, Rivers turned the red carpet of the Oscars, Emmys and Golden Globes into a stalking ground for E! Entertainment. Her familiar query — "Who are you wearing?" — would quickly give way to such snarky commentary as her assessment of Adele's Grammy outfit: The singer looked like she was sitting on a teapot.

The barbs could turn inward as well, with Rivers mocking everything from her proclaimed lack of sex appeal ("my best birth control now is just to leave the lights on") to her own mortality.

In 2007, Rivers and her partner-in-slime, daughter Melissa, were dropped by their new employer, the TV Guide Channel, and replaced by actress Lisa Rinna. But the Rivers' women found new success on E! with "Fashion Police," which Rivers hosted and her daughter produced.

Joan Rivers never relaxed, always looking for the next and better punchline.

"The trouble with me is, I make jokes too often," she told the AP in 2013, just days after the death of her older sister. "I was making jokes yesterday at the funeral home. That's how I get through life. Life is SO difficult — everybody's been through something! But you laugh at it, it becomes smaller."

She had faced true crisis in the mid-1980s. Edgar Rosenberg, her husband of 23 years, committed suicide in 1987 after she was fired from her Fox talk show, which he produced. The show's failure was a major factor, Rivers said. Rosenberg's suicide also temporarily derailed her career.

"Nobody wants to see someone whose husband has killed himself do comedy four weeks later," she told The New York Times in 1990.

Rivers had originally entered show business with the dream of being an actress, but comedy was a way to pay the bills while she auditioned for dramatic roles. "Somebody said, 'You can make six dollars standing up in a club,'" she told the AP, "and I said, 'Here I go!' It was better than typing all day."

In the early 1960s, comedy was a man's game and the only women comics she could look to were Totie Fields and Phyllis Diller. But she worked her way up from local clubs in New York until, in 1965, she landed her big break on "The Tonight Show" after numerous rejections. "God, you're funny. You're going to be a star," host Johnny Carson told her after she had rocked the audience with laughter.

Her nightclub career prospered and by late that year she had recorded her first comedy album, "Joan Rivers Presents Mr. Phyllis and Other Funny Stories." Her personal life picked up as well: She met British producer Rosenberg and they married after a four-day courtship.

Rivers hosted a morning talk show on NBC in 1968 and, the next year, made her Las Vegas debut with female comedians still a relative rarity.

"To control an audience is a very masculine thing," Rivers told the Los Angeles Times in 1977. "The minute a lady is in any form of power, they (the public) totally strip away your femininity — which isn't so. Catherine the Great had a great time."

In 1978, she wrote, directed and co-starred in the movie "Rabbit Test." It had an intriguing premise — Billy Crystal as a man who gets pregnant — but was poorly received. In 1983, though, she scored a coup when she was named permanent guest host for Carson on "Tonight."

Although she drew good ratings, NBC hesitated in renewing her contract three years later. Fledgling network Fox jumped in with an offer of her own late-night show.

She launched "The Late Show Starring Joan Rivers" on Fox in 1986, but the venture lasted just a season and came at a heavy price: Carson cut ties with her when she surprised him by becoming a competitor.

Carson kept publicly silent about her defection but referred obliquely to his new rival in his monologue on the day her show debuted.

"There are a lot of big confrontations this week," Carson said as the audience giggled expectantly. "Reagan and Gorbachev, the Mets versus the Astros, and me versus 'The Honeymooners' lost episodes."

Her show was gone in a year and she would declare that she had been "raped" by Fox; three months later, her husband was found dead.

It took two years to get her career going again, and then she didn't stop. Rivers appeared at clubs and on TV shows including "Hollywood Squares." She appeared on Broadway and released more comedy albums and books, most recently "Diary of a Mad Diva."

She was born Joan Molinsky in Brooklyn to Russian immigrants Meyer Molinsky, a doctor, and Beatrice. Rivers had a privileged upbringing but struggled with weight — she was a self-proclaimed "fatty" as a child — and recalled using make-believe as an escape. After graduating from Barnard College in 1954, she went to work as a department store fashion coordinator before she turned to comedy clubs. She had a six-month marriage to Jimmy Sanger.

In recent years, Rivers was a familiar face on TV shopping channel QVC, hawking her line of jewelry, and won the reality show "Celebrity Apprentice" by beating out her bitter adversary, poker champ Annie Duke. In 2010, she was featured in the documentary "Joan Rivers: A Piece of Work."

She never let age, or anything, make her sentimental. Earlier in 2014, she got inked: a half-inch-tall tattoo, "6M," on the inside of her arm representing 6 million Jews killed in the Nazi Holocaust. In 2013, she brashly pledged to work "forever."

"You never relax and say, 'Well, here I am!'" she declared. "You always think, 'Is this gonna be OK?' I have never taken anything for granted."

Survivors include her daughter, Melissa and a grandson, Cooper.