title: Thirty-day and one-year predictors of death in noncardiac major surgical procedures.
abstract: BACKGROUND
  We evaluated the predictive value of the American College of Cardiology/American Heart Association (ACC/AHA) cardiac risk classification, as well as other potential risk factors (procedure risk, smoking, obesity, hyperlipidemia, and renal insufficiency), on all-cause mortality at 30 days and at 1 year postoperatively.
  
  
  METHODS
  In the year 2000, 1238 consecutive patients undergoing general anesthesia for various noncardiac surgical procedures at the Houston Veterans Affairs Medical Center were screened preoperatively and classified according to the ACC/AHA guidelines. Patients' charts were reviewed for the above-mentioned risk factors.
  
  
  RESULTS
  A logistic regression analysis demonstrated that older age and higher procedure risk were associated with higher 30-day mortalities (P = 0.0012 and 0.0441, respectively). The ACC/AHA classification was positively correlated with mortality at 1 year (P = 0.0071).
  
  
  CONCLUSIONS
  The ACC/AHA classification predicts mortality at 1 year but not at 30 days for major noncardiac surgeries; procedure-related risk is a better predictor of 30-day postoperative mortality in our patient population.
authors.affiliation: Michael E. DeBakey Veteran Affairs Medical Center and Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Haytham M A
authors.initials: HM
authors.lastname: Kaafarani
authors.forename: Kamal M F
authors.initials: KM
authors.lastname: Itani
authors.forename: Jack
authors.initials: J
authors.lastname: Thornby
authors.forename: David H
authors.initials: DH
authors.lastname: Berger
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D002423:Cause of Death; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011183:Postoperative Complications / Q000401:mortality*; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods; D011336:Probability; D018570:Risk Assessment; D017678:Sex Distribution; D013514:Surgical Procedures, Operative / Q000379:methods* / Q000401:mortality*; D016019:Survival Analysis; D013997:Time Factors; D014481:United States