Most Read Articles
Stephen Padilla, 5 days ago
Early administration of recombinant human B-type natriuretic peptide (rhBNP) can lower the incidence of reperfusion injury for patients with ST-elevation myocardial infarction (STEMI) who are receiving percutaneous coronary intervention (PCI) treatment, according to a China study.
11 Aug 2019
Intraoperative methylprednisolone does not appear to significantly prevent the incidence of death, cardiac arrest and other injuries in neonates undergoing cardiac surgery with cardiopulmonary bypass, according to a recent study.
2 days ago
Pulmonary function has potential predictive value for future increases in arterial stiffness and its progression, as reported in a recent study.
Yesterday
Systolic blood pressure appears to have a strong association with aneurysmal subarachnoid haemorrhage (aSAH) but not with unruptured intracranial aneurysm (UIA), whereas current smoking and female sex are risk factors for both conditions, a study has found.

Novel CV risk index improves stratification of patients scheduled for noncardiac surgery

25 Jun 2019

A study has recently derived and validated a new index for preoperative cardiovascular evaluation, which can significantly contribute to the efficient triage and management of patients scheduled for noncardiac surgery. The new Cardiovascular Risk Index (CVRI) demonstrates a robust discriminatory power that can effectively stratify patients into low-, intermediate- and high-risk groups.

This study included a derivation cohort consisting of 3,284 prospectively enrolled adult patients undergoing noncardiac surgery at the American University of Beirut Medical Center and a validation cohort consisting of 1,167,414 patients registered in the American College of Surgeons National Surgical Quality Improvement Program database.

The primary outcome of death, myocardial infarction or stroke at 30 days after surgery occurred in 38 patients (1.2 percent) in the derivation cohort.

Six data elements to be included in the prediction model were identified in this cohort via multivariate logistic regression analysis: age ≥75 years, history of heart disease, symptoms of angina or dyspnoea, hemoglobin <12 mg/dl, vascular surgery, and emergency surgery. Each patient was assigned a CRVI of 0, 1, 2, 3 and >3 based on the number of data elements present.

Primary outcome incidence rose steadily across the CVRI groups in both the derivation (0 percent, 0.5 percent, 2.0 percent, 5.6 percent and 15.7 percent, respectively; p<0.0001) and validation (0.3 percent, 1.6 percent, 5.6 percent, 11.0 percent and 17.5 percent, respectively; p<0.0001) cohorts.

A receiver-operating characteristic curve, with respective areas under the curve of 0.90 and 0.82 in the derivation and validation cohorts, confirmed the discriminatory power of the new CVRI.

“Currently used indices for preoperative cardiovascular evaluation are either powerful, but complex, or simple, but with weak discriminatory power,” the authors said.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Doctor - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Stephen Padilla, 5 days ago
Early administration of recombinant human B-type natriuretic peptide (rhBNP) can lower the incidence of reperfusion injury for patients with ST-elevation myocardial infarction (STEMI) who are receiving percutaneous coronary intervention (PCI) treatment, according to a China study.
11 Aug 2019
Intraoperative methylprednisolone does not appear to significantly prevent the incidence of death, cardiac arrest and other injuries in neonates undergoing cardiac surgery with cardiopulmonary bypass, according to a recent study.
2 days ago
Pulmonary function has potential predictive value for future increases in arterial stiffness and its progression, as reported in a recent study.
Yesterday
Systolic blood pressure appears to have a strong association with aneurysmal subarachnoid haemorrhage (aSAH) but not with unruptured intracranial aneurysm (UIA), whereas current smoking and female sex are risk factors for both conditions, a study has found.