Prediction Score in Surgical Complications Estimation in the Practice of Internist

Котова, Д. П.; Котов, С. В.; Gilyarov, M. Yu.; Шеменкова, В. С.

doi:10.15829/1728-8800-2018-2-75-80

Cited by 8 publications

(2 citation statements)

References 16 publications

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“…больных. Она учитывает 67 параметров каждого пациента [27][28][29][30][31]. Как и EuroSCORE II, STS SCORE является простым в использовании онлайн-калькулятором (www.sts.org).…”

Section: результатыunclassified

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CarotidSCORE.RU — risk stratification for complications after carotid endarterectomy

et al. 2022

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Aim. To demonstrate the first Russian computer program (carotidscore.ru) for risk stratification of postoperative complications of carotid endarterectomy (CE).Material and methods. The present study is based on the analysis of a multicenter Russian database including 25812 patients after CE operated on from January 1, 2010 to April 1, 2022. The following types of CE were implemented: conventional CE with patch angioplasty — 6814 patients; eversion CE — 18998 patients. Following postoperative complications were assessed during the study: death, stroke, myocardial infarction (MI), composite endpoint (death + stroke + MI).Results. During inhospital postoperative period, 0,18% of participants died, while 0,14% had MI, 0,35% — stroke. The composite endpoint was recorded in 0,68%. For each factor present in patients, a predictive coefficient was estimated. The predictive coefficient was considered as a numerical parameter reflecting the strength of the effect of each factor on the development of postoperative complications. Based on this equation, predictive coefficients were calculated for each factor present in patients in our study. The total contribution of these factors was reflected as a percentage and denoted the risk of postoperative complications with a minimum of 0% and a maximum of 100%. On the basis of obtained calculations, a CarotidSCORE program was created. Its graphical interface is based on the QT framework. It is possible not only to estimate the risk of a complication, but also to save all data about a patient in JSON format. The CarotidSCORE program contains 47 patient parameters, including clinical, demographic, anamnestic and angiographic characteristics. It makes it possible to choose one of the four CE types, which will provide an accurate stratification of the complication risk for each of them.Conclusion. CarotidSCORE (carotidscore.ru) may determine the probability of postoperative complications in patients undergoing CE.

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Section: результатыunclassified

“…При этом летальный исход в STS SCORE является основной конечной точкой. Но есть данные, подтверждающие, что все-таки STS SCORE недооценивает периоперационный риск осложнений [27][28][29][30][31].…”

Section: результатыunclassified

CarotidSCORE.RU — risk stratification for complications after carotid endarterectomy

et al. 2022

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Perioperative infarction and myocardial injury: risk factors, mechanisms of development and clinical and epidemiological features

Shulenin

Черкашин

Solovyev

et al. 2022

Bulletin of the Russian Military Medical Academy

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Тhe concept, risk factors, mechanisms, clinical and epidemiological, and angiographic features of perioperative ischemic injury and myocardial infarction were considered. Perioperative myocardial infarction is one of the most common complications (up to 3.6%) in non-cardiac surgical interventions and is characterized by high in-hospital mortality, reaching 25%. Most patients with this pathology (up to 65%) do not have typical symptoms of myocardial ischemia due to anesthesia and sedation. Pathogenetic mechanisms of perioperative myocardial infarction development continues to be actively studied. A critical increase in myocardial oxygen demand is indicated as the leading cause in some studies. Angiography reveals rupture of the coronary plaque and atherothrombosis in more than half of patients, according to other data. These contradictions point to the need for further epidemiological studies using coronary angiography with a focus on risk factors and triggers of this complication. In addition, the concept of perioperative myocardial injury in recent years has been formulated in the scientific literature. This is understood as ischemic damage that occurs in the first 30 days after surgery. Recent studies have shown that it can occur in 16% of surgical patients and is associated with a 6-fold increase in mortality within 1 month after surgery and a 2.5-fold increase within a year. It is important that perioperative myocardial injury does not include cases of non-ischemic etiology myocardial injury, for example, due to pulmonary embolism, sepsis, or electrical cardioversion. Thus, the assessment and understanding of risk factors for the development of perioperative myocardial ischemia is of great practical importance in optimizing the patient selection and preparation for surgical treatment.

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Comparison of the results of preoperative assessment of cardiovascular risk and outcomes of surgical interventions for locally advanced abdominal cancer

Kutchev

Shulenin

Solovyev

et al. 2023

Bulletin of the Russian Military Medical Academy

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This retrospective study analyzed the structure of complications and mortality cases in 351 patients (men, n = 199; women, n = 152) aged 3389 years with locally advanced abdominal cancer and different cardiovascular risks in the early postoperative period, and two patient groups were formed. The main group consisted of 81 (23.1%) patients who died in the early postoperative period. The comparison group included 270 (76.9%) patients. In total, 311 (88.6%) patients underwent radical surgical intervention, whereas 40 (11.4%) underwent minimally invasive surgical treatment. Perioperative cardiovascular risk was stratified by calculating cardiac risk indices and using the database of the National Program for Improving the Quality of Surgical Care Myocardial Infarction and Cardiac Arrest. Fatal complications in the early postoperative period after surgical treatment of locally advanced abdominal cancer is significantly more often observed in patients with a more pronounced degree of tumor invasion, lymph node lesions, high class according to the standards of the American Society of Anesthesiologists, reduced functional status, prior hormone therapy, and combined anesthesia. The majority of fatal cases were associated with three complications, i.e., ventricular arrhythmias (53%), acute decompensation of heart failure (46%), and multiple organ failure (43%). Approximately 95% of deaths were associated with increased postoperative cardiovascular risk, and 52% were medium-risk cases. Hospital mortality at low risk was noted in 4.9%, average in 27.8%, and high in 32.7% of the patients. In cases with a favorable course, surgical complications were predominant over cardiovascular ones. The use of calculated cardiac risk indices and database of the National Program for Improving the Quality of Surgical Care Myocardial Infarction and Cardiac Arrest confirmed their high ability to predict the development of cardiovascular complications, which are the leading causes of death in the early postoperative period in patients who underwent surgical interventions for locally advanced abdominal cancer.

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Prediction Score in Surgical Complications Estimation in the Practice of Internist

Cited by 8 publications

References 16 publications

CarotidSCORE.RU — risk stratification for complications after carotid endarterectomy

CarotidSCORE.RU — risk stratification for complications after carotid endarterectomy

Perioperative infarction and myocardial injury: risk factors, mechanisms of development and clinical and epidemiological features

Comparison of the results of preoperative assessment of cardiovascular risk and outcomes of surgical interventions for locally advanced abdominal cancer

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