Impact of the Choice of Risk Model for Identifying Low-risk Patients Using the 2014 American College of Cardiology/American Heart Association Perioperative Guidelines

Anesthesiology
Laurent G GlanceAndrew W Dick

Abstract

WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: The 2014 American College of Cardiology Perioperative Guideline recommends risk stratifying patients scheduled to undergo noncardiac surgery using either: (1) the Revised Cardiac Index; (2) the American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator; or (3) the Myocardial Infarction or Cardiac Arrest calculator. The aim of this study is to determine how often these three risk-prediction tools agree on the classification of patients as low risk (less than 1%) of major adverse cardiac event. This is a retrospective observational study using a sample of 10,000 patient records. The risk of cardiac complications was calculated for the Revised Cardiac Index and the Myocardial Infarction or Cardiac Arrest models using published coefficients, and for the American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator using the publicly available website. The authors used the intraclass correlation coefficient and kappa analysis to quantify the degree of agreement between these three risk-prediction tools. There is good agreement between the American College of Surgeons National Surgical Quality Improvemen...Continue Reading

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Citations

Oct 17, 2018·Anesthesiology·Jonathan P Wanderer, James P Rathmell
Jan 17, 2019·Anesthesia and Analgesia·Lee A FleisherDuminda N Wijeysundera
Jul 18, 2019·Anesthesiology·Steven L Cohn, Nerea Fernandez Ros
Jul 18, 2019·Anesthesiology·Laurent G GlanceAndrew W Dick
Apr 24, 2020·Current Opinion in Anaesthesiology·Radmilo J JankovicDanica Markovic
Nov 25, 2020·International Anesthesiology Clinics·Nidhi Rohatgi, Steven L Cohn
Apr 9, 2021·Circulation·Curtis BeneschUNKNOWN American Heart Association Stroke Council; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiova
Jul 29, 2021·International Anesthesiology Clinics·Richard P DuttonAesha S Shukla

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