Addition of biomarker panel improves prediction performance of American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) calculator for cardiac risk assessment of elderly patients preparing for major non-cardiac surgery: a pilot study

Marković, Danica; Jevtović-Stoimenov, Tatjana; Ćosić, Vladan; Stosic, Biljana; Živković, Bojana; Janković, Radmilo

doi:10.1007/s40520-017-0805-9

Cited by 12 publications

(5 citation statements)

References 49 publications

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“…This shows a substantial gap in implementing these protocols among surgical residents at our medical facility. The participants in the study exhibited limited proficiency with the ACS-NSQIP Surgical Risk Calculator, which contrasts with the increasing body of research supporting its effectiveness in enhancing patient outcomes and promoting collaborative decision-making (Bilimoria et al, 2013;Marković et al, 2018;McMillan et al, 2017). Our results align with the findings of Cohen et al (2015), who highlighted how failure to engage with risk calculators and contemporary data-driven methods may hinder advancements towards improved surgical practices and patient care consequences (Cohen et al, 2016).…”

Section: Discussionsupporting

confidence: 63%

Approach and Understanding of Surgical Trainees Towards the Use of Universal Acs-Nsqip Surgical Risk Calculator, and Clinical Data Keeping and Its Audit

JAWAID,

ZAHEER,

SHARAFAT

et al. 2024

Biol Clin Sci Res J

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Clinical audit methods and surgical risk calculators are paramount in advancing surgical protocols and enhancing patient outcomes. The objective is to assess surgical trainees' approach and understanding of using the Universal ACS-NSQIP Surgical Risk Calculator and clinical data keeping and its audit to improve surgical practices and patient outcomes. A cross-sectional study was administered among 71 surgical trainees at Dr. Ruth K. M. Pfau Civil Hospital Karachi to assess their understanding, perspectives, and behaviors about using the risk calculator and procedures for data management. To gather this information, a questionnaire-based survey was utilized to collect data, which was analyzed via SPSS. The participants displayed limited familiarity (9.9%, n=7) and implementation (0%) of the ACS-NSQIP Surgical Risk Calculator in the clinical practice of surgical trainees. Despite most participants expressing confidence in the calculator's reliability (71.4%) and advocating for its integration into surgical practice (85.7%), its utilization remains non-existent. Moreover, while every participant acknowledged the significance of mantaining patient records and conducting audits, only 22.5% reported participating in clinical data audits. Furthermore, most surgical residents relied on clinical intuitions and conventional sources such as textbooks for patient consultations. There is a notable gap between the comprehension and utilization of the Universal ACS-NSQIP Surgical Risk Calculator among surgical residents. This research emphasizes the necessity to comprehend and utilize for incorporating evidence-based instruments such as the Universal ACS-NSQIP Surgical Risk Calculator and implement rigorous data management and review protocols to cultivate a culture of quality enhancement and optimize patient outcomes. This can be attained through initiatives such as educational programs, enhanced availability of resources, and improved assistance for the compilation and evaluation of data.

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Section: Discussionsupporting

confidence: 63%

Approach and Understanding of Surgical Trainees Towards the Use of Universal Acs-Nsqip Surgical Risk Calculator, and Clinical Data Keeping and Its Audit

JAWAID,

ZAHEER,

SHARAFAT

et al. 2024

Biol Clin Sci Res J

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“…[ 40 ], may be more accurate in older patients. The ACS-NSQIP Surgical Risk Calculator [ 41 ] has been specifically validated in geriatric patients, and is an accurate tool for preoperative assessment in this population, especially if combined with cardiac biomarkers [ 42 ].…”

Section: Preoperative Assessment and Optimizationmentioning

confidence: 99%

Perioperative Management of Elderly patients (PriME): recommendations from an Italian intersociety consensus

et al. 2020

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Background Surgical outcomes in geriatric patients may be complicated by factors such as multiple comorbidities, low functional performance, frailty, reduced homeostatic capacity, and cognitive impairment. An integrated multidisciplinary approach to management is, therefore, essential in this population, but at present, the use of such an approach is uncommon. The Perioperative Management of Elderly patients (PriME) project has been established to address this issue. Aims To develop evidence-based recommendations for the integrated care of geriatric surgical patients. Methods A 14-member Expert Task Force of surgeons, anesthetists, and geriatricians was established to develop evidence-based recommendations for the pre-, intra-, and postoperative care of hospitalized older patients (≥ 65 years) undergoing elective surgery. A modified Delphi approach was used to achieve consensus, and the strength of recommendations and quality of evidence was rated using the U.S. Preventative Services Task Force criteria. Results A total of 81 recommendations were proposed, covering preoperative evaluation and care (30 items), intraoperative management (19 items), and postoperative care and discharge (32 items). Conclusions These recommendations should facilitate the multidisciplinary management of older surgical patients, integrating the expertise of the surgeon, the anesthetist, the geriatrician, and other specialists and health care professionals (where available) as needed. These roles may vary according to the phase and setting of care and the patient’s conditions.

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“…Associations between H-FABP and ACS 6 – 8 , acute kidney injury 9 , post-cardiac surgery 10 , acute pulmonary embolism 11 , acute ischemic stroke 12 , severe sepsis 13 , acute heart failure 14 , hypothyroidism 15 and hyperthyroidism 16 have been reported over the past decades. On the other hand, H-FABP has also been used to assess perioperative cardiac risk 17 , 18 . However, the prognostic implication of H-FABP in patients with stable coronary heart disease (SCHD) is unknown.…”

Section: Introductionmentioning

confidence: 99%

The prognostic significance of heart-type fatty acid binding protein in patients with stable coronary heart disease

Tseng

et al. 2018

Sci Rep

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To investigate the prognostic value of heart-type fatty acid binding protein (H-FABP) in patients with stable coronary heart disease (SCHD). A total of 1,071 patients with SCHD were prospectively enrolled in this Taiwan multicenter registry study, followed for 24 months. The cut-off value of H-FABP, 4.143 pg/mL, was determined using receiver operating characteristic curves. The primary cardiovascular (CV) outcome was composite CV events, defined as cardiovascular or cerebrovascular death, myocardial infarction (MI), stroke, angina related-hospitalization, PAOD-related hospitalization and heart failure. Secondary outcomes included CV or cerebrovascular death, nonfatal MI, nonfatal stroke, and acute heart failure-related hospitalization. We found that the high H-FABP group had more than a two-fold higher rate of primary CV outcomes than the low H-FABP group (32.36% vs. 15.78%, p < 0.001). Eleven patients (4.82%) of the high H-FABP group died during the 24 months of follow-up, compared to only one patient (0.12%) in the low H-FABP group. The acute heart failure-related hospitalization rate was also significantly higher in the high H-FABP group (3.5% vs. 0.95%, p < 0.005). The results remained significant after adjusting for baseline covariates. In conclusion, H-FABP was an independent predictor for CV outcomes in the patients with SCHD, mainly in CV death and acute heart failure-related hospitalization.

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Addition of biomarker panel improves prediction performance of American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) calculator for cardiac risk assessment of elderly patients preparing for major non-cardiac surgery: a pilot study

Abstract: Our results indicate that ACS NSQIP represents an accurate tool for preoperative assessment of elderly patients, especially if combined with cardiac biomarkers.

Cited by 12 publications

References 49 publications

Approach and Understanding of Surgical Trainees Towards the Use of Universal Acs-Nsqip Surgical Risk Calculator, and Clinical Data Keeping and Its Audit

Approach and Understanding of Surgical Trainees Towards the Use of Universal Acs-Nsqip Surgical Risk Calculator, and Clinical Data Keeping and Its Audit

Perioperative Management of Elderly patients (PriME): recommendations from an Italian intersociety consensus

The prognostic significance of heart-type fatty acid binding protein in patients with stable coronary heart disease

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