What preoperative variables predict fatal or life-threatening cardiac complications in patients undergoing non-cardiac surgery?
A clinical prediction model utilizing six routine preoperative variables can effectively discriminate the risk of severe cardiac complications in patients undergoing non-cardiac surgery.
This prospective study was carried out to develop a model for the prediction of cardiac risk in non-cardiac surgery. Detailed data were collected concerning the preoperative status of 2609 consecutive patients, who were followed closely during the postoperative course. Fatal or life-threatening cardiac complications occurred in 68 patients (2.6%). By utilizing logistic regression, a model for prediction of cardiac risk was developed. The model contained six significant preoperative predictor variables: Congestive heart failure (with 3 degrees of severity); ischaemic heart disease (with 2 degrees of severity); diabetes mellitus; serum creatinine above 0.13 mmol l-1; emergency operation; and the type of operation (two categories). With this model it seems possible to discriminate between patients with very different levels of cardiac risk.
Larsen et al. (Sun,) studied this question.