Prediction of Perioperative Risk: The Glass May Be Three-Quarters Full
Authors: David S. Bach, Kim A. Eagle
Journal: Annals of Internal Medicine (2000)

Editorials5 September 2000Prediction of Perioperative Risk: The Glass May Be Three-Quarters FullDavid S. Bach, MD and Kim A. Eagle, MDDavid S. Bach, MDFrom University of Michigan; Ann Arbor, MI 48109-0273Search for more papers by this author and Kim A. Eagle, MDFrom University of Michigan; Ann Arbor, MI 48109-0273Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-133-5-200009050-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Patients who undergo noncardiac surgery may be at risk for adverse cardiovascular events in the perioperative period. Many studies have shown that readily accessible clinical markers can be used to identify high-risk patients. Such markers typically include factors that are specific to the patient as well as to the planned surgical procedure. When predicting cardiovascular risk, the consulting physician seeks to identify patients who have increased perioperative and long-term risk for adverse events. He or she then tries to decrease short-term and long-term risk by instituting appropriate therapy. Several algorithms have been developed to quantify risk, and although they differ, ...References1. Gilbert K, Larocque BJ, Patrick LT. Prospective evaluation of cardiac risk indices for patients undergoing noncardiac surgery. Ann Intern Med. 2000;133:356-9. LinkGoogle Scholar2. New classification of physical status. American Society of Anesthesiologists. Anesthesiology. 1963; 24:111. Google Scholar3. 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. CrossrefMedlineGoogle Scholar4. 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. CrossrefMedlineGoogle Scholar5. American College of Physicians. Guidelines for assessing and managing the perioperative risk from coronary artery disease associated with major noncardiac surgery. Ann Intern Med. 1997;127:309-12. LinkGoogle Scholar6. Campeau L. Letter: Grading of angina pectoris. Circulation. 1976;54:522-3. CrossrefMedlineGoogle Scholar7. Eagle KA, Brundage BH, Chaitman BR, Ewy GA, Fleisher LA, Hertzer NR, et al . Guidelines for perioperative cardiovascular evaluation for noncardiac surgery. Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Peri-operative Cardiovascular Evaluation for Noncardiac Surgery). Circulation. 1996;93:1278-317. MedlineGoogle Scholar8. Bayes T. An essay toward solving a problem in the doctrine of chances. Philos Trans R Soc Lond B Biol Sci. 1763;53:370-418. Google Scholar9. Poldermans D, Boersma E, Bax JJ, Thomson IR, van de Ven LL, Blankensteijn JD, et al . The effect of bisoprolol on perioperative mortality and myocardial infarction in high-risk patients undergoing vascular surgery. N Engl J Med. 1999;341:1789-94. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: David S. Bach, MD; Kim A. Eagle, MDAffiliations: From University of Michigan; Ann Arbor, MI 48109-0273Corresponding Author: David S. Bach, MD, Division of Cardiology, University of Michigan, L3119 Women's—0273, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0273; e-mail, [email protected]edu.Current Author Addresses: Drs. Bach and Eagle: Division of Cardiology, University of Michigan, L3119 Women's—0273, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0273. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoProspective Evaluation of Cardiac Risk Indices for Patients Undergoing Noncardiac Surgery Kenneth Gilbert , Brian J. Larocque , and Lawrence T. Patrick Comparison of Cardiac Risk Indices Peter M. Clarke Metrics Cited byPrevention of Perioperative Myocardial InfarctionWrinkling of epoxy powder coatingsModest serum creatinine elevation affects adverse outcome after general surgeryPOSTOPERATIVE PULMONARY COMPLICATIONSComparison of Cardiac Risk IndicesPeter M. Clarke, MDProspective Evaluation of Cardiac Risk Indices for Patients Undergoing Noncardiac Surgery 5 September 2000Volume 133, Issue 5Page: 384-386KeywordsAdverse eventsAlgorithmsBayesian methodBiomarkersCoronary revascularizationReceiver operating characteristic curveRisk managementSurgeryThoracic surgeryUnstable angina ePublished: 5 September 2000 Issue Published: 5 September 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...