Multicenter study of perioperative evaluation for noncardiac surgeries in Brazil (EMAPO).
BACKGROUND
The accuracy of perioperative evaluation methods available is better than chance, but their performance is not ideal.


OBJECTIVE
To compare a new evaluation method (EMAPO) to the American College of Physicians method for determining the risk of cardiovascular complications in noncardiac surgeries and to look for new influencing variables.


METHODS
Evaluations through EMAPO and the American College of Physicians method were employed for 700 patients. Cardiac events and deaths were recorded, the risk variables related to the occurrence of complications were verified, and the models were compared by analyzing the areas under the receiver operating characteristic curves.


RESULTS
Mortality rate was 3.4%, and the incidence of cardiovascular complications was 5.3%. Renal failure (P = 0.01), major surgery (P = 0.004), and emergency surgery (P = 0.003) were independently related to the occurrence of cardiovascular complications. The two methods produced similar results.


CONCLUSIONS
EMAPO is as good as the American College of Physicians method in determining the risk of cardiovascular complications in noncardiac surgeries. New variables related to surgical risk were identified.
Pinho
Claudio
C
Pontifical Catholic University of Campinas, Campinas, SP, Brazil.
Grandini
Paulo C
PC
Gualandro
Danielle M
DM
Calderaro
Daniela
D
Monachini
Maristela
M
Caramelli
Bruno
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000572:American Heart Association; D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D019990:Perioperative Care; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D017410:Practice Guidelines as Topic / Q000592:standards*; D051437:Renal Insufficiency / Q000150:complications; D013514:Surgical Procedures, Operative / Q000009:adverse effects* / Q000401:mortality