TY - JOUR
T1 - Preoperative evaluation in noncardiac surgery
T2 - Cardiac risk assessment
AU - Maggio, Cristina
AU - Bonzano, Alessandro
AU - Conte, Enrica
AU - Libertucci, Daniela
AU - Panarelli, Maurizio
AU - Bobbio, Marco
AU - Pinna Pintor, Plinio
PY - 1992
Y1 - 1992
N2 - Nine hundred and ninety patients, ages 20 years or older, undergoing non-cardiac elective surgery were prospectively studied to identify high cardiac risk preoperative factors in a case-mix population and to assess cardiological risk. The prevalence of major cardiac complications was 2.3%, including 0.8% mortality. Univariate analysis showed that: age; history of chest pain; dyspnea; hypertension; presence of systolic murmur and third sound; diastolic pressure >95 mmHg; electrocardiogram left ventricular hypertrophy; cardiothoracic ratio >0.5 and valvular calcifications are associated with cardiac complications (p 0.001-0.02), with low sensitivity (range: 14-38%) and high specificity (range: 85-98%). Cardiological referral was required for 169 patients (17%) that showed a higher prevalence of cardiovascular diseases (85%) and of cardiac complications (5.3%). Cardiologists required further tests for 13 patients (7.7%) and modified therapy for 93 (55%). High cardiac risk patients are identified preoperatively in current practice and cardiological referral is frequent; further studies are mandatory to evaluate the most effective and efficacious procedures.
AB - Nine hundred and ninety patients, ages 20 years or older, undergoing non-cardiac elective surgery were prospectively studied to identify high cardiac risk preoperative factors in a case-mix population and to assess cardiological risk. The prevalence of major cardiac complications was 2.3%, including 0.8% mortality. Univariate analysis showed that: age; history of chest pain; dyspnea; hypertension; presence of systolic murmur and third sound; diastolic pressure >95 mmHg; electrocardiogram left ventricular hypertrophy; cardiothoracic ratio >0.5 and valvular calcifications are associated with cardiac complications (p 0.001-0.02), with low sensitivity (range: 14-38%) and high specificity (range: 85-98%). Cardiological referral was required for 169 patients (17%) that showed a higher prevalence of cardiovascular diseases (85%) and of cardiac complications (5.3%). Cardiologists required further tests for 13 patients (7.7%) and modified therapy for 93 (55%). High cardiac risk patients are identified preoperatively in current practice and cardiological referral is frequent; further studies are mandatory to evaluate the most effective and efficacious procedures.
KW - Cardiac risk
KW - Preoperative evaluation
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U2 - 10.1093/oxfordjournals.intqhc.a036722
DO - 10.1093/oxfordjournals.intqhc.a036722
M3 - Article
AN - SCOPUS:84959805570
VL - 4
SP - 217
EP - 224
JO - International Journal for Quality in Health Care
JF - International Journal for Quality in Health Care
SN - 1353-4505
IS - 3
ER -