A new 6-variable Cardiovascular Risk Index strongly predicted 30-day death, myocardial infarction, or stroke after noncardiac surgery, with an AUC of 0.90 in derivation and 0.82 in validation.
Cohort (n=1,170,698)
Sí
Can a simple 6-element Cardiovascular Risk Index (CVRI) accurately stratify the 30-day risk of death, MI, or stroke in patients undergoing noncardiac surgery?
A simple 6-element Cardiovascular Risk Index provides strong discriminatory power for predicting 30-day cardiovascular events in patients undergoing noncardiac surgery.
Estimación del efecto: AUC 0.90 (derivation), 0.82 (validation)
valor p: p=< 0.0001
BACKGROUND Currently used indices for pre-operative cardiovascular evaluation are either powerful, but complex, or simple, but with weak discriminatory power. OBJECTIVES This study sought to prospectively derive and validate a simple powerful index that can stratify the cardiovascular risk of patients undergoing noncardiac surgery. METHODS The derivation cohort consisted of 3,284 prospectively enrolled adult patients undergoing noncardiac surgery at the American University of Beirut Medical Center. The validation cohort consisted of 1,167,414 patients registered in the American College of Surgeons National Surgical Quality Improvement Program database. The primary outcome measure was death, myocardial infarction, or stroke at 30 days after surgery. RESULTS The primary outcome occurred in 38 patients (1.2%) in the derivation cohort. Multivariate logistic regression analysis in the derivation cohort identified 6 data elements to be included in the prediction model: age ≥75 years, history of heart disease, symptoms of angina or dyspnea, hemoglobin 3 based on the number of data elements present. The incidence of the primary outcome increased steadily across the CVRI groups in both the derivation (0%, 0.5%, 2.0%, 5.6%, and 15.7%, respectively; p 3) groups. This has important implications for the efficient triage and management of patients scheduled for noncardiac surgery.
“This time, they didn't mention anything about preference”
Dakik et al. (Sat,) conducted a cohort in Patients undergoing noncardiac surgery (n=1,170,698). Cardiovascular Risk Index (CVRI) vs. Low CVRI score (0) was evaluated on Death, myocardial infarction, or stroke at 30 days after surgery (AUC 0.90 (derivation), 0.82 (validation), p=< 0.0001). A new 6-variable Cardiovascular Risk Index strongly predicted 30-day death, myocardial infarction, or stroke after noncardiac surgery, with an AUC of 0.90 in derivation and 0.82 in validation.