Cardiac assessment for patients undergoing noncardiac surgery. A multifactorial clinical risk index.
In this article, we describe a multifactorial cardiac risk index that can be used to assess patients undergoing noncardiac surgery. The index is a modified version of an index that was previously generated by Goldman and coworkers on a set of 1001 consecutive patients and prospectively validated in our clinical setting (a general medical consultation service in a large teaching hospital) on 455 patients. We present a Bayesian approach to assessing cardiac risks by converting average risks for patients undergoing particular surgical procedures (pretest probabilities) to average risks for patients with each index score (posttest probabilities). A simple nomogram is presented for performing such a calculation.
D000368:Aged; D000369:Aged, 80 and over; D001499:Bayes Theorem; D005260:Female; D006331:Heart Diseases / Q000209:etiology*; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D011654:Pulmonary Edema / Q000209:etiology; D012306:Risk; D013514:Surgical Procedures, Operative