title: Perioperative evaluation of cardiac surgical risk: particularities in the emergency surgery - from the guidelines to the clinical practice.
abstract: BACKGROUND
  Cardiac risk in patients undergoing surgery depends on many factors from the patient's cardiovascular history to the surgical procedure itself, with its particularities, the type of anesthesia, fluid exchanges and the supervision of the patient. Therefore, this risk must be carefully considered and it determines the endorsement of perioperative measures with important medical implications.
  
  
  OBJECTIVE
  Perioperative cardiac risk evaluation guidelines were published since 2010 and they represent a highly important assessmnet tool. Emergency surgery requires an adaptation of the guidelines to the actual medical situations in extreme conditions. METHODS, RESULTS, DISCUSSION: Analyzing the way the perioperative evaluation itself is conducted is an extremely important tool. Quantifying the clinical application of the guidelines, one can monitor real parameters and find solutions for improving medical care. The current study was conducted on a representative sample of 8326 patients, respecting the recommendation strategies for calculating the surgical risk adapted for the emergency surgery setting. The dominant conclusion is the need to develop a standardized form, summarized for quick and objective assessment of perioperative cardiac risk score. Only a complex medical team could calculate this score while the decisional team leader for the surgical patient remains the surgeon.
authors.affiliation: 1st Internal Medicine and Cardiology Department, "Sfantul Pantelimon" Clinical Emergency Hospital Bucharest ; "Carol Davila" University of Medicine and Pharmacy Bucharest.
authors.forename: A M
authors.initials: AM
authors.lastname: Andronescu
authors.forename: A C
authors.initials: AC
authors.lastname: Nechita
authors.forename: G
authors.initials: G
authors.lastname: Ittu
authors.forename: C
authors.initials: C
authors.lastname: Delcea
authors.forename: G
authors.initials: G
authors.lastname: Dumitrescu
authors.forename: M M
authors.initials: MM
authors.lastname: Vintila
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D013504:Cardiovascular Surgical Procedures / Q000009:adverse effects*; D004562:Electrocardiography; D004632:Emergency Medical Services; D006334:Heart Function Tests; D006439:Hemodynamics; D006801:Humans; D019990:Perioperative Care; D017410:Practice Guidelines as Topic; D012307:Risk Factors
chemical_list: D015415:Biomarkers
keywords: pemergency surgery; perioperative cardiac risk; perioperative evaluation