title: A comparison of clinical index and ejection fractions in predicting cardiac complications following infrarenal aortic reconstruction.
abstract: OBJECTIVE
  To compare the Detsky clinical cardiac risk index with ejection fraction measurements in predicting postoperative cardiac events.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  District General Hospital.
  
  
  METHODS
  48 patients undergoing infrarenal aortic reconstruction.
  
  
  METHODS
  Ejection fractions were measured both by echocardiography and a technetium 99 MUGA scan.
  
  
  RESULTS
  Three patients developed four major cardiac events (LVF three, fatal myocardial infarction one). Fourteen patients experienced 15 minor cardiac events (arrhythmia 11, ST segment depression four). The clinical index predicted postoperative cardiac problems (p = 0.0001). There was no correlation between ejection fraction measurement and postoperative cardiac events nor between ejection fraction measurements and the clinical index. Combining the index with ejection fraction measurement provided no additional information over the index alone.
  
  
  CONCLUSIONS
  Calculation of a clinical index before aortic reconstruction is a simple and reliable way of selecting patients who are at risk of developing postoperative cardiac events.
authors.affiliation: Royal Berkshire Hospital, Reading, U.K.
authors.forename: R B
authors.initials: RB
authors.lastname: Galland
authors.forename: J A
authors.initials: JA
authors.lastname: Michaels
authors.forename: A
authors.initials: A
authors.lastname: Toms
authors.forename: A
authors.initials: A
authors.lastname: Whyman
authors.forename: K
authors.initials: K
authors.lastname: Luxton
authors.forename: J A
authors.initials: JA
authors.lastname: Bell
authors.forename: C
authors.initials: C
authors.lastname: Verghese
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000601:surgery*; D001281:Atrial Fibrillation / Q000209:etiology; D002302:Cardiac Output; D002303:Cardiac Output, Low / Q000209:etiology; D004452:Echocardiography; D005260:Female; D005544:Forecasting; D015637:Gated Blood-Pool Imaging; D006331:Heart Diseases / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D011183:Postoperative Complications; D011446:Prospective Studies; D013318:Stroke Volume; D013616:Tachycardia, Sinus / Q000209:etiology; D013667:Technetium; D018487:Ventricular Dysfunction, Left / Q000209:etiology
chemical_list: D013667:Technetium