Validation of the European Society of Cardiology and European Society of Anaesthesiology non-cardiac surgery risk score in patients treated with coronary drug-eluting stent implantation

Norderud, Kanutte; Egholm, Gro; Thim, Troels; Olesen, Kevin Kris Warnakula; Madsen, Morten; Jensen, Lisette Okkels; Bøtker, Hans Erik; Kristensen, Steen Dalby; Mæng, Michael

doi:10.1093/ehjqcco/qcy032

Cited by 17 publications

(13 citation statements)

References 14 publications

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“…Methods predicting postoperative cardiac events using appropriate preoperative evaluations, e.g., risk stratification, have been comprehensively studied [9,[14][15][16]. The RCRI was designed to predict postoperative MI, pulmonary edema, ventricular fibrillation or cardiac arrest, and complete heart block.…”

Section: Discussionmentioning

confidence: 99%

“…ECG findings included the presence of atrial fibrillation and ST-T changes, and QRS duration (ms). In addition, patient anesthesia type, the risk of surgery, and the revised cardiac risk index (RCRI) scores were included, and the risk of major cardiac adverse events according to the type of surgery was classified into high (> 5%), intermediate (1 ~ 5%), and low risk (< 1%) [14,15].…”

Section: Data Collectionmentioning

confidence: 99%

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Preoperative cardiac troponin I as a predictor of postoperative cardiac events in patients with end stage renal disease undergoing non-cardiac surgery

et al. 2022

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We investigated if elevated cardiac troponin I (cTnI) serum levels before non-cardiac surgery were predictors of postoperative cardiac events in patients with end stage renal disease (ESRD) undergoing dialysis. In total, 703 consecutive patients with ESRD undergoing dialysis who underwent non-cardiac surgery were enrolled. Preoperative cTnI serum levels were measured at least once in all patients. The primary endpoint was defined as a composite of cardiac death, myocardial infarction (MI), and pulmonary edema during hospitalization or within 30 days after surgery in patients with a hospitalization longer than 30 days after surgery. Postoperative cardiac events occurred in 48 (6.8%) out of 703 patients (cardiac death 1, MI 18, and pulmonary edema 33). Diabetes mellitus (DM), previous ischemic heart disease, and congestive heart failure were more common in patients with postoperative cardiac events. Peak cTnI serum levels were higher in patients with postoperative cardiac event (180 ± 420 ng/L vs. 80 ± 190 ng/L, p = 0.008), and also elevated peak cTnI levels > 45 ng/L were more common in patients with postoperative cardiac events (66.8% vs. 30.5%, p < 0.001). Multivariate logistic regression analysis showed that DM (odds ratio [OR] 2.509, 95% confidence interval [CI] 1.178-5.345, p = 0.017) and serum peak cTnI levels ≥ 45 ng/L (OR 3.167, 95% CI 1.557-6.444, p = 0.001) were independent predictors for the primary outcome of cardiac death/MI/pulmonary edema. Moreover, cTnI levels ≥ 45 ng/L had an incremental prognostic value to the revised cardiac risk index (RCRI) (Chi-square = 23, p < 0.001), and to the combined RCRI and left ventricular ejection fraction (Chi-square = 12, p = 0.001). Elevated preoperative cTnI levels are predictors of postoperative cardiac events including cardiac death, MI, and pulmonary edema in patients with ESRD undergoing non-cardiac surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Data Collectionmentioning

confidence: 99%

Preoperative cardiac troponin I as a predictor of postoperative cardiac events in patients with end stage renal disease undergoing non-cardiac surgery

et al. 2022

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“…Type of surgery was categorized as low-, intermediate-, or high-risk procedure according to ESC and European Society of Anesthesiology noncardiac surgery (ESC/ESA-NCS) guidelines. 16 , 17 The first noncardiac surgery was considered when a patient underwent surgery multiple times.…”

Section: Methodsmentioning

confidence: 99%

Risk and Timing of Noncardiac Surgery After Transcatheter Aortic Valve Implantation

et al. 2022

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“…The type of surgery was classified as low, intermediate, or high risk based on the European Society of Cardiology and European Society of Anaesthesiology non-cardiac surgery risk score. 18 Postoperative hypotension was defined as having a systolic blood pressure of below 90mmHg for more than 5 minutes.…”

Section: Methodsmentioning

confidence: 99%

Incidence and risk factors of delirium in post-anaesthesia care unit

Chew

Seet

et al. 2022

Ann Acad Med Singap

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Introduction: Post-anaesthesia care unit (PACU) delirium is a potentially preventable condition that results in a significant long-term effect. In a multicentre prospective cohort study, we investigate the incidence and risk factors of postoperative delirium in elderly patients undergoing major non-cardiac surgery. Methods: Patients were consented and recruited from 4 major hospitals in Singapore. Research ethics approval was obtained. Patients older than 65 years undergoing non-cardiac surgery >2 hours were recruited. Baseline perioperative data were collected. Preoperative baseline cognition was obtained. Patients were assessed in the post-anaesthesia care unit for delirium 30–60 minutes after arrival using the Nursing Delirium Screening Scale (Nu-DESC). Results: Ninety-eight patients completed the study. Eleven patients (11.2%) had postoperative delirium. Patients who had PACU delirium were older (74.6±3.2 versus 70.6±4.4 years, P=0.005). Univariate analysis showed those who had PACU delirium are more likely to be ASA 3 (63.6% vs 31.0%, P=0.019), had estimated glomerular filtration rate (eGFR) of <60mL/min/1.73m2 (36.4% vs 10.6%, P=0.013), higher HbA1C value (7.8±1.2 vs 6.6±0.9, P=0.011), raised random blood glucose (10.0±5.0mmol/L vs 6.5±2.4mmol/L, P=0.0066), and moderate-severe depression (18.2% vs 1.1%, P=0.033). They are more likely to stay longer in hospital (median 8 days [range 4–18] vs 4 days [range 2–8], P=0.049). Raised random blood glucose is independently associated with increased PACU delirium on multivariate analysis. Conclusion: PACU delirium is common in elderly patients with risks factors presenting for major surgery. Keywords: Geriatrics, major non-cardiac surgery, postoperative delirium

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Validation of the European Society of Cardiology and European Society of Anaesthesiology non-cardiac surgery risk score in patients treated with coronary drug-eluting stent implantation

Abstract: The ESC/ESA-NCS classification is a valid tool to predict the risk of both MACE and the combined endpoint of mortality and myocardial infarction for patients undergoing NCS.

Cited by 17 publications

References 14 publications

Preoperative cardiac troponin I as a predictor of postoperative cardiac events in patients with end stage renal disease undergoing non-cardiac surgery

Preoperative cardiac troponin I as a predictor of postoperative cardiac events in patients with end stage renal disease undergoing non-cardiac surgery

Risk and Timing of Noncardiac Surgery After Transcatheter Aortic Valve Implantation

Incidence and risk factors of delirium in post-anaesthesia care unit

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