Preoperative Echocardiography for Noncardiac Surgery
Authors: Ethan A. Halm
Journal: Annals of Internal Medicine (1997)

Letters1 June 1997Preoperative Echocardiography for Noncardiac SurgeryEthan A. Halm, MD, Warren S. Browner, MD, MPH, and Julio F. Tubau, MDEthan A. Halm, MDMassachusetts General Hospital, Boston, MA 02114Veterans Affairs Medical Center, San Francisco, CA 94121University of Southern California, Los Angeles, CA 90033Search for more papers by this author, Warren S. Browner, MD, MPHMassachusetts General Hospital, Boston, MA 02114Veterans Affairs Medical Center, San Francisco, CA 94121University of Southern California, Los Angeles, CA 90033Search for more papers by this author, and Julio F. Tubau, MDMassachusetts General Hospital, Boston, MA 02114Veterans Affairs Medical Center, San Francisco, CA 94121University of Southern California, Los Angeles, CA 90033Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-11-199706010-00028 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Palen wonders about “the manner in which information from the traditional clinical evaluation was incorporated into the clinical model” of cardiac risk. For each cardiac event, we used stepwise multivariable regression to identify the clinical factors that were the best predictors of the outcome of interest and then added the echocardiographic data to that “best” clinical model to see whether the diagnostic test added any incremental information. For example, our clinical model of all cardiac outcomes included vascular surgery, history of dysrhythmia, definite coronary artery disease, and use of digoxin (see Tables 4 and 7 in our ...References1. 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. Google Scholar2. 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. Google Scholar3. Mangano DT, Browner WS, Hollengberg M, London MJ, Tubau JF, Tateo IM, et al. Association of perioperative myocardial ischemia with cardiac morbidity and mortality in men undergoing noncardiac surgery. N Engl J Med. 1990; 323:1781-8. Google Scholar4. Amico AF, Lichtenberg GS, Reisner SA, Stone CK, Schwartz RG, Meltzer RS. Superiority of visual versus computerized echocardiographic estimation of radionuclide LVEF. Am Heart J. 1989; 118:1259-65. Google Scholar5. Van Royen N, Jaffe CC, Krumholz HM, Johnson KM, Lynch PJ, et al. Comparison and reproducibility of visual echocardiographic and quantitative radionuclide left ventricular ejection fractions. Am J Cardiol. 1996; 77:843-50. Google Scholar Author, Article, and Disclosure InformationAuthors: Ethan A. Halm, MD; Warren S. Browner, MD, MPH; Julio F. Tubau, MDAffiliations: Massachusetts General Hospital, Boston, MA 02114Veterans Affairs Medical Center, San Francisco, CA 94121University of Southern California, Los Angeles, CA 90033 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1997Volume 126, Issue 11Page: 919-920KeywordsCardiac surgeryEchocardiographyEjection fractionReproducibilityRisk assessmentsRisk managementStable coronary artery diseaseSurgeryVascular surgeryVentricular tachycardia ePublished: 15 August 2000 Issue Published: 1 June 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...