Preoperative evaluation in noncardiac surgery: Cardiac risk assessment

Cristina Maggio, Alessandro Bonzano, Enrica Conte, Daniela Libertucci, Maurizio Panarelli, Marco Bobbio, Plinio Pinna Pintor

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)217-224
Number of pages8
JournalInternational Journal for Quality in Health Care
Volume4
Issue number3
DOIs
Publication statusPublished - 1992

Keywords

  • Cardiac risk
  • Preoperative evaluation

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

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