title: Prospective assessment of different indices of cardiac risk for patients undergoing noncardiac surgeries.
abstract: OBJECTIVE
  To compare the accuracy of 4 different indices of cardiac risk currently used for predicting perioperative cardiac complications.
  
  
  METHODS
  We studied 119 patients at a university-affiliated hospital whose cardiac assessment had been required for noncardiac surgery. Predictive factors of high risk for perioperative cardiac complications were assessed through clinical history and physical examination, and the patients were followed up after surgery until the 4th postoperative day to assess the occurrence of cardiac events. All patients were classified according to 4 indices of cardiac risk: the Goldman risk-factor index, Detsky modified risk index, Larsen index, and the American Society of Anesthesiologists' physical status classification and their compared accuracies, examining the areas under their respective receiver operating characteristic (ROC) curves.
  
  
  RESULTS
  Cardiac complications occurred in 16% of the patients. The areas under the ROC curves were equal for the Goldman risk-factor index, the Larsen index, and the American Society of Anesthesiologists' physical status classification: 0.48 (SEM +/- 0.03). For the Detsky index, the value found was 0.38 (SEM +/- 0.03). This difference in the values was not statistically significant.
  
  
  CONCLUSIONS
  The cardiac risk indices currently used did not show a better accuracy than that obtained randomly. None of the indices proved to be significantly better than the others. Studies to improve our ability to predict such complications are still required.
authors.affiliation: Universidade Federal de Santa Catarina, Florianápolis, SC, Brazil. heinisch@hu.ufsc.br
authors.forename: Roberto Henrique
authors.initials: RH
authors.lastname: Heinisch
authors.forename: Caroline Ferrari
authors.initials: CF
authors.lastname: Barbieri
authors.forename: João Rogério
authors.initials: JR
authors.lastname: Nunes Filho
authors.forename: Glauce Lippi de
authors.initials: GL
authors.lastname: Oliveira
authors.forename: Liana Miriam Miranda
authors.initials: LM
authors.lastname: Heinisch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016021:Epidemiologic Studies; D005260:Female; D006331:Heart Diseases / Q000209:etiology*; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D013514:Surgical Procedures, Operative / Q000009:adverse effects*