The original Revised Cardiac Risk Index showed poor predictive ability for 30-day postoperative major cardiac events (AUC 0.53; 95% CI 0.45-0.61), performing significantly worse than a modified score.
Observational (n=1,202)
Sí
Does the revised Cardiac Risk Index (RCRI) accurately predict postoperative major cardiac events in older Chinese patients with coronary artery disease undergoing noncardiac surgery?
The widely used Revised Cardiac Risk Index has poor predictive ability for postoperative cardiac events in older Chinese patients with CAD undergoing noncardiac surgery, highlighting the need for population-specific or modified risk models.
Estimación del efecto: AUC 0.53 (95% CI 0.45-0.61)
valor p: p=<0.01
Objectives: The revised Cardiac Risk Index (RCRI) is the most widely used risk prediction tool for postoperative cardiac adverse events. We aim to explore the predictive ability of the RCRI in older Chinese patients with coronary artery disease (CAD) undergoing noncardiac surgery, which has not been previously evaluated. Methods: We performed a multicenter, prospective study. We enrolled a total of 1,202 patients, aged >60 years, with a history of CAD who underwent noncardiac surgery. Perioperative data were extracted from an electronic database. The primary end point was defined as an occurrence of a postoperative major cardiac event (PoMCE) within 30 days. Logistic regression analysis was performed to evaluate the performance of the RCRI. A modified RCRI was created and compared with the original RCRI with regard to its ability to predict postoperative cardiac events. Results: Of the enrolled patients, 4.3% experienced PoMCE. Most components of the RCRI were not predictive of postoperative cardiac events with the exception of insulin-dependent diabetes mellitus (odds ratio =2.38, 95% CI: 1.11–5.11; P =0.03). The RCRI performed no better than chance (area under the curve =0.53; 95% CI: 0.45–0.61) in identifying patients’ cardiac risk. The modified score had a higher discriminatory ability toward PoMCE (c index, 0.69 versus 0.53; P <0.01). Conclusion: The original RCRI shows poor predictive ability in Chinese patients with CAD undergoing noncardiac surgery. Keywords: cardiovascular risk factors, older patient, coronary artery disease, risk prediction model
Che et al. (Fri,) conducted a observational in Coronary artery disease undergoing noncardiac surgery (n=1,202). Revised Cardiac Risk Index (RCRI) vs. Modified RCRI was evaluated on Occurrence of a postoperative major cardiac event (PoMCE) within 30 days (AUC 0.53, 95% CI 0.45-0.61, p=<0.01). The original Revised Cardiac Risk Index showed poor predictive ability for 30-day postoperative major cardiac events (AUC 0.53; 95% CI 0.45-0.61), performing significantly worse than a modified score.
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