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Reduction in mortality from cardiac causes in goldman class IV patients

K Shah1, B Kleinman, T Rao

  • 1Loyola University Medical Center, Maywood, IL, USA.

Journal of Cardiothoracic Anesthesia
|December 1, 1988
PubMed

Insights

High-risk cardiac patients undergoing non-cardiac surgery show reduced cardiac death rates. Advances in patient care likely explain the significant decrease in mortality for these vulnerable individuals.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Anesthesiology

Background:

  • The 1977 Goldman et al. study identified high cardiac mortality in patients undergoing non-cardiac surgery.
  • Goldman class IV patients represent a high-risk group for perioperative cardiac events.

Purpose of the Study:

  • To prospectively evaluate current cardiac death and overall mortality rates in Goldman class IV patients.
  • To compare current mortality data with historical findings from the 1977 Goldman study.

Main Methods:

  • Prospective evaluation of 49 patients classified as Goldman class IV.
  • Monitoring for cardiac death and overall mortality during the study period.

Main Results:

  • Cardiac death occurred in 8.2% of patients (4/49).
  • Overall mortality was 22.4% (11/49), with 7 deaths from non-cardiac causes.
  • A significant reduction in cardiac mortality from 56% (1977) to 8.2% was observed.

Conclusions:

  • Current cardiac mortality in high-risk surgical patients has substantially decreased compared to 1977 data.
  • Advances in perioperative patient care are likely responsible for the observed reduction in cardiac mortality.

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