Prospective assessment of different indices of cardiac risk for patients undergoing noncardiac surgeries

Heinisch, Roberto Henrique; Barbieri, Caroline Ferrari; Filho, João Rogério Nunes; Oliveira, Glauce Lippi de; Heinisch, Liana Miriam Miranda

doi:10.1590/s0066-782x2002001300001

Cited by 15 publications

(10 citation statements)

References 13 publications

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“…In the preoperative evaluation, each factor is added; the higher the sum, the greater the risk of death due to a cardiac reason and of life-threatening cardiac events, such as myocardial infarction, pulmonary edema, and ventricular tachycardia. 10 …”

Section: Introductionmentioning

confidence: 99%

Comorbidities, clinical intercurrences, and factors associated with mortality in elderly patients admitted for a hip fracture

Edelmuth¹,

Sorio²,

Sprovieri³

et al. 2018

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveTo analyze comorbidities and clinical complications, and to determine the factors associated with mortality rates of elderly patients admitted with a hip fracture in a tertiary public hospital.MethodsSixty-seven medical records were reviewed in a retrospective cohort study, including patients equal to or older than 65 years admitted to this institution for hip fracture between January 2014 and December 2014. The evaluated items constituted were the following: interval of time between fracture and hospital admission, time between admission and surgical procedure, comorbidities, clinical complications, type of orthopedic procedure, surgical risk, cardiac risk, and patient outcome.ResultsThe average patients’ age in the sample was 77.6 years, with a predominance of the female gender. Most patients (50.7%) had two or more comorbidities. The main clinical complications during hospitalization included cognitive behavioral disorders, respiratory infection and of the urinary tract. The times between fracture and admission and between admission and surgery were more than seven days in most of cases. The mortality rate during hospitalization was 11.9%, and was directly connected to the presence of infections during hospital stay (p = 0.006), to time between admission and surgery longer than seven days (p = 0.005), to the Goldman Cardiac Risk Index class III (p = 0.008), and to age equal to or greater than 85 years (p = 0.031).ConclusionPatients with hip fractures generally present comorbidities, are susceptible to clinical complications, and have an 11.9% mortality rate.

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Section: Introductionmentioning

confidence: 99%

Comorbidities, clinical intercurrences, and factors associated with mortality in elderly patients admitted for a hip fracture

Edelmuth¹,

Sorio²,

Sprovieri³

et al. 2018

Revista Brasileira de Ortopedia (English Edition)

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“…It concluded that none of the indexes analyzed were significantly superior to the others and that they did not show better accuracy than that which would be obtained by chance, according to the results found: areas under the ROC curve 0.48 (± 0.03) for the Goldman, ASA and Larsen scale and 0.38 (± 0.03) for the Detsky scale. 11 Another prospective study compared the EMAPO to the ACP method to determine heart risk in non-cardiac surgeries and to find new variables involved in determining this risk. The results revealed that there was no difference between the two methods, and that the EMAPO was as effective as the American College of Physicians for determining the risk of cardiovascular complications.…”

Section: Discussionmentioning

confidence: 99%

Agreement between three perioperative risk scores

Feitosa-Filho

Loureiro

Nascimento

2016

Rev. Assoc. Med. Bras.

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Objective: To evaluate the agreement between the three scores proposed by the II Guideline for Perioperative Evaluation of the Brazilian Society of Cardiology (SBC): the American College of Physicians algorithm (ACP), the Multicenter Study of Perioperative Evaluation (EMAPO) and Lee's Revised Cardiac Risk Index (RCRI). Method: Patients evaluated preoperatively for non-cardiac surgery by the anesthesiology service were classified as low, moderate or high-risk according to the 3 algorithms suggested by the II Guideline. To calculate the strength of agreement between the scores, the kappa agreement index was used. Results: Four hundred and one patients were included in the sample. Cohen's kappa inter-rater agreement between scores was 0.270 (CI: 0.222 to 0.318), corresponding to a weak agreement. Analyzing in pairs, the best correlation was between EMAPO and ACP, with kappa = 0.327. Lee's score was the one that classified more patients as low-risk: 98.3%, while EMAPO and ACP classified as low risk 91.3% and 92.5%, respectively. Conclusion: There is poor correlation among the risk scores proposed by the II Perioperative Evaluation Guideline of the SBC.

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“…These algorithms are not perfect 28 , but all of them are better than chance in predicting perioperative complications and should be used during the evaluation. All of them have advantages and disadvantages that should be considered during their use.…”

Section: Considerations On the Preoperative Cardiac Evaluation Algorimentioning

confidence: 99%

II Diretriz de Avaliação Perioperatória da Sociedade Brasileira de Cardiologia

Feitosa¹,

Marques²,

Caramelli³

et al. 2011

Arq. Bras. Cardiol.

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Prospective assessment of different indices of cardiac risk for patients undergoing noncardiac surgeries

Abstract: The cardiac risk indices currently used did not show a better accuracy than that obtained randomly. None of the indices proved to be significantly better than the others. Studies to improve our ability to predict such complications are still required.

Cited by 15 publications

References 13 publications

Comorbidities, clinical intercurrences, and factors associated with mortality in elderly patients admitted for a hip fracture

Comorbidities, clinical intercurrences, and factors associated with mortality in elderly patients admitted for a hip fracture

Agreement between three perioperative risk scores

II Diretriz de Avaliação Perioperatória da Sociedade Brasileira de Cardiologia

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