Measurement of central hemodynamic parameters during preoperative exercise testing in patients suspected of arteriosclerotic heart disease. Value in predicting postoperative cardiac complications.
The object of this study was to investigate whether the history, general clinical examination, chest radiography, ECG, and preoperative exercise haemodynamics afforded a basis for pointing out individuals who were likely to develop postoperative cardiac complications. Particular emphasis was placed on whether haemodynamic testing yielded a major contribution to predicting such complications. 48 patients carried out preoperative exercise tests. The hemodynamic parameters were obtained by using a Swan-Ganz pulmonary artery thermodilution catheter. The clinical examinations, laboratory findings, and haemodynamic parameters were assessed by comparing the results with the outcome of the postoperative course. In assessing the results, the same diagnostic accuracy was found for the history (0.56-0.65), laboratory findings (0.50-0.65), and hemodynamic parameters (0.44-0.71). By combining the various parameters, however, it was possible to achieve a very high sensitivity (0.86) as regards the prediction of postoperative cardiac complications, but this was at the cost of many false positives and consequently a low accuracy (0.46). We conclude that haemodynamic exercise testing is not better than conventional means of prediction individual patient's postoperative cardiac complications.
D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D005080:Exercise Test; D005260:Female; D006331:Heart Diseases / Q000209:etiology*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D013223:Statistics as Topic