Information Value of Calculated Hematological Indices in the Assessment of Cardiac Risk in Oncological Surgery

The objective was to perform a comparative analysis of the information content of potential predictors of cardiovascular complications of various types in patients operated on for vascular diseases. Materials and Methods. We examined 129 patients aged 66 [61–70] years who underwent elective vascular surgery. We analyzed comorbidity, general clinical indicators, special cardiac risk indices and biomarkers: N-terminal segment of B-type natriuretic peptide prohormone (NT-proBNP) and cardiospecific troponin I. We used logistic regression and ROC analysis. Results. 21 (16.3 %) perioperative cardiovascular complications were registered in 17 (13.2 %) patients. In one-factor regression, the predictors of cardiovascular complications were coronary heart disease (OR 4.5904; 95 % CI 1.3119–5.9340; p = 0.0171), combination of coronary heart disease and chronic heart failure (OR 2.9419; 95 % CI 1.0140–8.5350; p = 0.047), ASA class > 3 (OR 2.9402; 95 % CI 1.0304–8.3899; p = 0.0438), high cardiac risk surgery (OR 3.4741; 95 % CI 1.1162-10.8126; p = 0.0316), Lee cardiac risk index (OR 2.2353; 95 % CI 1.2842–3.8911; p = 0.0045), the American College of Surgeons cardiac risk index for assessing the risk of perioperative myocardial infarction or cardiac arrest (OR 1.5312; 95 % CI 1.0927–2.1456; p = 0.0133) and the preoperative level of the N-terminal prohormone B-type natriuretic peptide (NT-proBNP) (OR 1.0048; 95 % CI 1.0021–1.0074; p = 0.0004). In multivariate regression, the predictors of cardiovascular complications were high-risk cardiac surgery (OR 5.7439; 95 % CI 1.1027–29.9181; p = 0.0379) and NT-proBNP (OR 1.0044; 95 % CI 1.0015–1.0073; p = 0.0033). The biomarker level > 218 pg/ml discriminated against cardiovascular complications with sensitivity of 82.4 % and specificity of 85.3 % (AUC 0.825; 95 % CI 0.747–0.887; p < 0.0001). Conclusion. In vascular interventions, the most significant predictors of cardiovascular complications are high-risk cardiac surgery and the preoperative level of NT-proBNP > 218 pg/ml with a sensitivity and specificity level exceeding 80 %.

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Predictive accuracy of cardiac risk indices for cardiovascular complications in patients undergoing noncardiac surgery

Соколов

Tymoshenko

Chervyakov

et al. 2023

Innovacionnaâ medicina Kubani

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Objective: To compare predictive accuracy of the American Society of Anesthesiologists (ASA) score and various cardiac risk indices for perioperative cardiovascular (CV) complications in patients undergoing noncardiac surgery.Materials and methods: We examined 243 patients (148 men and 95 women) aged 45 to 84 (66 [60-71] years) prior to their elective oncological and vascular surgery. We assessed patients using the ASA physical status classification system, Revised Cardiac Risk Index (RCRI), Gupta Myocardial Infarct or Cardiac Arrest (MICA) calculator, and Khoronenko cardiac risk index and analyzed perioperative CV complications.Results: We detected complications in 30 (12.3%) patients, with 3 (1.24%) of them having 2 concomitant CV complications. One death (0.41%) was registered. The MICA risk calculator had the highest predictive value (AUC ROC = 0.753). Risk scores over 0.95% discriminated patients with perioperative CV complications with sensitivity and specificity of 73.3% and 67.45%, respectively.Conclusions: We recommend using the MICA risk calculator to predict perioperative CV complications following elective oncological and vascular surgery.

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Information Value of Calculated Hematological Indices in the Assessment of Cardiac Risk in Oncological Surgery

Cited by 5 publications

References 37 publications

Accuracy of predictors of perioperative cardiovascular complications in onco-surgery

Accuracy of predictors of perioperative cardiovascular complications in onco-surgery

Informativeness of various predictors of perioperative cardiovascular complications in non-cardiac surgery

Predictive accuracy of cardiac risk indices for cardiovascular complications in patients undergoing noncardiac surgery

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