A New Tool for Assessing Cardiac Risk in Noncardiac Surgery

One purpose of a preoperative medical evaluation is to determine a patient's risk for cardiac complications. These researchers developed an index for predicting cardiac complications (i.e., myocardial infarction, pulmonary edema, ventricular fibrillation, cardiac arrest, and complete heart block) among patients undergoing major nonemergent noncardiac surgery. The index was derived from 2,893 patients and validated in 1,422 patients, all aged 50 or older.

The model identified six independent predictors of cardiac complications: high-risk surgery, history of ischemic heart disease, history of congestive heart failure, history of cerebrovascular disease, insulin therapy, and serum creatinine above 2.0 mg/dl. In the derivation cohort, the presen…