Validating the Thoracic Revised Cardiac Risk Index Following Lung Resection

The Annals of Thoracic Surgery
Daniel C ThomasAnthony W Kim

Abstract

The Thoracic Revised Cardiac Index (ThRCRI) is a tool that differentiates patients who may proceed to lung resection (classes A or B) from those who should receive additional cardiac evaluation (classes C or D). This study aims to describe the ability of the ThRCRI to stratify patients based on major cardiac complication rates using a large multi-institutional dataset. Patients undergoing lobectomy or pneumonectomy were identified in the American College of Surgeons National Surgical Quality Improvement Program dataset from 2005 to 2012. Patients were grouped into 4 risk classes based on a summary score of preoperative risk factors: ischemic heart disease, cerebrovascular disease, renal comorbidity, and pneumonectomy. The primary outcome was the incidence of perioperative major cardiac complication in each of the 4 risk classes. Of the 4,625 patients identified, the majority underwent surgery for malignant disease (78%) and had an open procedure (70%). Among ThRCRI risk factors, 9% of patients had ischemic heart disease, 7% had cerebrovascular disease, 2% had renal comorbidity, and 6% underwent pneumonectomy. Incidence of cardiac complication in all patients was 2%. Incidence of cardiac complication within risk classes A, B, C,...Continue Reading

Citations

Oct 28, 2020·Expert Review of Respiratory Medicine·Gaelle DauriatElie Fadel
Aug 18, 2020·The Annals of Thoracic Surgery·Audrey L KhouryJason M Long
Jan 18, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Ciara HanleyPeter Slinger
Jul 4, 2021·Revue des maladies respiratoires·H Etienne, J Assouad
Nov 5, 2021·Pneumologie·Klaus-Marius BastianCorinna Ludwig

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