Agreement between three perioperative risk scores.
OBJECTIVE
To evaluate the agreement between the three scores proposed by the II Guideline for Perioperative Evaluation of the Brazilian Society of Cardiology (SBC): the American College of Physicians algorithm (ACP), the Multicenter Study of Perioperative Evaluation (EMAPO) and Lee's Revised Cardiac Risk Index (RCRI).


METHODS
Patients evaluated preoperatively for non-cardiac surgery by the anesthesiology service were classified as low, moderate or high-risk according to the 3 algorithms suggested by the II Guideline. To calculate the strength of agreement between the scores, the kappa agreement index was used.


RESULTS
Four hundred and one patients were included in the sample. Cohen's kappa inter-rater agreement between scores was 0.270 (CI: 0.222 to 0.318), corresponding to a weak agreement. Analyzing in pairs, the best correlation was between EMAPO and ACP, with kappa = 0.327. Lee's score was the one that classified more patients as low-risk: 98.3%, while EMAPO and ACP classified as low risk 91.3% and 92.5%, respectively.


CONCLUSIONS
There is poor correlation among the risk scores proposed by the II Perioperative Evaluation Guideline of the SBC.
Escola Bahiana de Medicina e Saúde Pública, Escola Bahiana de Medicina e Saúde Pública, Salvador BA , Brazil, PhD in Cardiology from Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (InCor-HCFMUSP). Adjunct Professor, Escola Bahiana de Medicina e Saúde Pública. Coordinator of Research Records at Hospital Santa Izabel - Santa Casa de Misericórdia da Bahia, Salvador, BA, Brazil.
Gilson Soares
GS
Feitosa-Filho
Escola Bahiana de Medicina e Saúde Pública, Escola Bahiana de Medicina e Saúde Pública, Salvador BA , Brazil, Medical Student, Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil.
Bruna Melo Coelho
BM
Loureiro
Santa Casa de Misericórdia da Bahia, Salvador BA , Brazil, PhD in Anesthesiology - Responsible for the Medical Residency in Anesthesiology at Santa Casa de Misericórdia da Bahia, Salvador, BA, Brazil.
Jedson Dos Santos
Jdos S
Nascimento
D000328:Adult; D001938:Brazil; D002318:Cardiovascular Diseases / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D059035:Perioperative Period / Q000379:methods*; D017410:Practice Guidelines as Topic / Q000592:standards; D012016:Reference Values; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors