Carta Revisado por pares

The Revised Cardiac Risk Index Delivers What It Promised

2010; American College of Physicians; Volume: 152; Issue: 1 Linguagem: Inglês

10.7326/0003-4819-152-1-201001050-00013

ISSN

1539-3704

Autores

Lee Goldman,

Tópico(s)

Aortic aneurysm repair treatments

Resumo

Editorials5 January 2010The Revised Cardiac Risk Index Delivers What It PromisedLee Goldman, MD, MPHLee Goldman, MD, MPHFrom Columbia University, New York, NY 10032.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-1-201001050-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail When tested in a variety of settings in different types of patients and using inconsistent methods for gathering data and defining outcomes, the Revised Cardiac Risk Index (RCRI) (1) performed essentially identically for predicting major perioperative cardiac complications in 9 studies of more than 5000 patients undergoing mixed major noncardiac surgery over the past decade as it did among the patients on whom it was derived. These data, as presented by Ford and colleagues in this issue (2), show that the RCRI delivered what it promised and confirm it as the best available predictive index, with an admirable accuracy (3), ...References1. Lee TH, Marcantonio ER, Mangione CM, Thomas EJ, Polanczyk CA, Cook EF, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation. 1999;100:1043-9. [PMID: 10477528] CrossrefMedlineGoogle Scholar2. Ford MK, Beattie WS, Wijeysundera DN. Systematic review: prediction of perioperative cardiac complications and mortality by the Revised Cardiac Risk Index. Ann Intern Med. 2010;152:26-35. LinkGoogle Scholar3. Cook NR. Use and misuse of the receiver operating characteristic curve in risk prediction. Circulation. 2007;115:928-35. [PMID: 17309939] CrossrefMedlineGoogle Scholar4. Goldman L, Caldera DL, Nussbaum SR, Southwick FS, Krogstad D, Murray B, et al. Multifactorial index of cardiac risk in noncardiac surgical procedures. N Engl J Med. 1977;297:845-50. [PMID: 904659] CrossrefMedlineGoogle Scholar5. Detsky AS, Abrams HB, McLaughlin JR, Drucker DJ, Sasson Z, Johnston N, et al. Predicting cardiac complications in patients undergoing non-cardiac surgery. J Gen Intern Med. 1986;1:211-9. [PMID: 3772593] CrossrefMedlineGoogle Scholar6. Wasson JH, Sox HC, Neff RK, Goldman L. Clinical prediction rules. Applications and methodological standards. N Engl J Med. 1985;313:793-9. [PMID: 3897864] CrossrefMedlineGoogle Scholar7. Rohde LE, Polanczyk CA, Goldman L, Cook EF, Lee RT, Lee TH. Usefulness of transthoracic echocardiography as a tool for risk stratification of patients undergoing major noncardiac surgery. Am J Cardiol. 2001;87:505-9. [PMID: 11230829] CrossrefMedlineGoogle Scholar8. Kertai MD, Bountioukos M, Boersma E, Bax JJ, Thomson IR, Sozzi F, et al. Aortic stenosis: an underestimated risk factor for perioperative complications in patients undergoing noncardiac surgery. Am J Med. 2004;116:8-13. [PMID: 14706659] CrossrefMedlineGoogle Scholar9. Yang H, Raymer K, Butler R, Parlow J, Roberts R. The effects of perioperative beta-blockade: results of the Metoprolol after Vascular Surgery (MaVS) study, a randomized controlled trial. Am Heart J. 2006;152:983-90. [PMID: 17070177] CrossrefMedlineGoogle Scholar10. Bartels C, Bechtel JF, Hossmann V, Horsch S. Cardiac risk stratification for high-risk vascular surgery. Circulation. 1997;95:2473-5. [PMID: 9184575] CrossrefMedlineGoogle Scholar11. Archan S, Roscher CR, Fairman RM, Fleisher LA. Revised Cardiac Risk Index (Lee) and perioperative cardiac events as predictors of long-term mortality in patients undergoing endovascular abdominal aortic aneurysm repair. J Cardiothorac Vasc Anesth. 2009. [Epub ahead of print]. [PMID: 19556144] Google Scholar12. Kumar R, McKinney WP, Raj G, Heudebert GR, Heller HJ, Koetting M, et al. Adverse cardiac events after surgery: assessing risk in a veteran population. J Gen Intern Med. 2001;16:507-18. [PMID: 11556926] CrossrefMedlineGoogle Scholar13. Boersma E, Kertai MD, Schouten O, Bax JJ, Noordzij P, Steyerberg EW, et al. Perioperative cardiovascular mortality in noncardiac surgery: validation of the Lee cardiac risk index. Am J Med. 2005;118:1134-41. [PMID: 16194645] CrossrefMedlineGoogle Scholar14. Lee TH, Thomas EJ, Ludwig LE, Sacks DB, Johnson PA, Donaldson MC, et al. Troponin T as a marker for myocardial ischemia in patients undergoing major noncardiac surgery. Am J Cardiol. 1996;77:1031-6. [PMID: 8644653] CrossrefMedlineGoogle Scholar15. Fleischmann KE, Goldman L, Young B, Lee TH. Association between cardiac and noncardiac complications in patients undergoing noncardiac surgery: outcomes and effects on length of stay. Am J Med. 2003;115:515-20. [PMID: 14599629] CrossrefMedlineGoogle Scholar16. Neary WD, Prytherch D, Foy C, Heather BP, Earnshaw JJ. Comparison of different methods of risk stratification in urgent and emergency surgery. Br J Surg. 2007;94:1300-5. [PMID: 17541986] CrossrefMedlineGoogle Scholar17. Fleischmann KE, Beckman JA, Buller CE, Calkins H, Fleisher LA, Freeman WK, et al. 2009 ACCF/AHA focused update on perioperative beta blockade: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2009;120:2123-51. [PMID: 19884474] CrossrefMedlineGoogle Scholar18. Leibowitz AB, Porter SB. Perioperative beta-blockade in patients undergoing noncardiac surgery: a review of the major randomized clinical trials. J Cardiothorac Vasc Anesth. 2009;23:684-93. [PMID: 19303328] CrossrefMedlineGoogle Scholar19. Monaco M, Stassano P, Di Tommaso L, Pepino P, Giordano A, Pinna GB, et al. Systematic strategy of prophylactic coronary angiography improves long-term outcome after major vascular surgery in medium- to high-risk patients: a prospective, randomized study. J Am Coll Cardiol. 2009;54:989-96. [PMID: 19729114] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Columbia University, New York, NY 10032.Disclosures: None disclosed.Corresponding Author: Lee Goldman, MD, MPH, Columbia University, 630 West 168th Street, P&S 2-401, New York, NY 10032; e-mail, [email protected]edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSystematic Review: Prediction of Perioperative Cardiac Complications and Mortality by the Revised Cardiac Risk Index Meredith K. Ford , W. Scott Beattie , and Duminda N. Wijeysundera Metrics Cited ByPreoperative multidisciplinary team decisions for high-risk patients scheduled for noncardiac surgery—a retrospective observational studyA Simple, Reliable, and Validated Preoperative Cardiac Risk IndexPerioperative Risk ModelsEstimation of Cardiac Risk Before Noncardiac Surgery: The Evolution of Cardiac Risk IndicesValidation of a Risk Stratification Index and Risk Quantification Index for Predicting Patient OutcomesThe Surgical Mortality Probability ModelWhat We Talk about When We Talk about Risk: Refining Surgery's Hazards in Medical ThoughtRischio in anestesiaUtility of clinical risk predictors for preoperative cardiovascular risk predictionIndex de risque cardiaque et chirurgie vasculaire : Pas les mêmes pour tousCardiac Risk Index and Vascular Surgery: Not the Same for EveryoneLa gestione perioperatoria del paziente con insufficienza cardiaca cronica 5 January 2010Volume 152, Issue 1Page: 57-58KeywordsCardiac surgeryCreatineMedical risk factorsMyocardial infarctionProspective studiesStenosisSurgeryTroponinVascular surgery ePublished: 5 January 2010 Issue Published: 5 January 2010 CopyrightCopyright © 2010 by American College of Physicians. 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