Cardiac risk and peripheral vascular surgery: New approach based on a multifactorial risk index
✍ Scribed by Dr. L. Jivegård; I. Frid; H. Haljamäe; B. Hallenberg; J. Holm; S. R. Johansson
- Publisher
- John Wiley and Sons
- Year
- 1993
- Tongue
- English
- Weight
- 617 KB
- Volume
- 80
- Category
- Article
- ISSN
- 0007-1323
No coin nor oath required. For personal study only.
✦ Synopsis
An inexpensive approach to stratification of patients admitted for arterial surgery into groups of high and low cardiac risk has been prospectively evaluated in 235 consecutive patients. The Goldman and Detsky indices, assessed by a nurse the day before surgery, both identijiedpatient groups with increased risk of lethal or potentially lethal (myocardial infarction, pulmonary oedema) cardiac events within 30 days after peripheral vascular surgery. The Goldman index was the more sensitive predictor of cardiac death (overall frequency 3.1 per cent) while the Detsky index was superior for prediction of non-lethal cardiac events (overall frequency 5.9 per cent). The simplest and yet most efective stratijication into high and low cardiac risk was achieved using a Detsky score of I0 as the cut-of. It is concluded that multfactorial risk index-based preoperative screening can identfy low-risk patients (Detsky score < l o ) , who may be accepted f o r vascular surgery (aortic aneurysm surgery excluded) without additional cardiac testing.