Related Experiment Video
Updated: May 7, 2026
Assessment of Cardiac Function and Myocardial Morphology Using Small Animal Look-locker Inversion Recovery (SALLI) MRI in Rats
Published on: July 19, 2013
The South African Vascular Surgical Cardiac Risk Index (SAVS-CRI): a prospective observational study
Yoshan Moodley1, Prebashini Naidoo, Bruce M Biccard
1Perioperative Research Group, Department of Anaesthetics, Nelson R Mandela School of Medicine, University of Kwazulu-Natal, and Inkosi Albert Luthuli Central Hospital, Durban, South Africa. moodleyyo@ukzn.ac.za.
Insights
The Revised Cardiac Risk Index (RCRI) is unsuitable for vascular surgery patients. A new South African Vascular Surgical Cardiac Risk Index (SAVS-CRI) shows promise for predicting cardiovascular events in this population.
Area of Science:
- Cardiology
- Vascular Surgery
- Epidemiology
Background:
- The Revised Cardiac Risk Index (RCRI) may not be appropriate for cardiovascular risk stratification in vascular surgery patients.
- There is a need for a specific risk index tailored to vascular surgery populations.
Purpose of the Study:
- To identify cardiovascular risk factors in South African vascular surgery patients.
- To develop the South African Vascular Surgical Cardiac Risk Index (SAVS-CRI) for predicting major adverse cardiovascular events (MACEs).
Main Methods:
- Prospective data collection on peri-operative MACEs in elective vascular surgery patients in Durban, South Africa (2008-2011).
- Binary logistic regression used to identify independent predictors of MACEs.
- Development of a risk index to stratify patients into low, intermediate, and high-risk groups.
Main Results:
- Six independent predictors of MACEs identified: age >65, ischemic heart disease, diabetes, chronic beta-blockade, prior coronary revascularization, and surgical procedure type.
- The developed risk model demonstrated better discrimination between risk groups compared to the RCRI.
Conclusions:
- The RCRI is inappropriate for cardiovascular risk stratification in vascular surgery patients.
- The SAVS-CRI shows potential for improved risk stratification in this patient group.
- Independent validation of the SAVS-CRI is necessary.
Background:
Recent evidence suggests that application of the Revised Cardiac Risk Index (RCRI) for peri-operative cardiovascular risk stratification in vascular surgery patients may be inappropriate, necessitating the development of risk indices specific to vascular surgery patients.
Objectives:
To identify risk factors for cardiovascular morbidity and mortality in South African patients undergoing major vascular surgery, and to develop an appropriate cardiovascular risk stratification index, the South African Vascular Surgical Cardiac Risk Index (SAVS-CRI), which could be used to predict the risk of peri-operative major adverse cardiovascular events (MACEs) in South African vascular surgery patients.
Methods:
We prospectively collected data related to peri-operative MACE occurrence and established risk factors for peri-operative MACEs from adult patients who underwent elective vascular surgery at a tertiary hospital in Durban, South Africa, between February 2008 and March 2011. We determined independent predictors of peri-operative MACEs in our cohort by binary logistic regression and used the identified predictors to create a risk index that stratified patients into low-, intermediate- or high-risk groups.
Results:
Six independent predictors of peri-operative MACEs were identified in the vascular surgery cohort: age >65 years, a history of ischaemic heart disease, a history of diabetes, chronic β-blockade, prior coronary revascularisation, and the vascular surgical procedure. The risk model derived from these risk factors appeared to discriminate between the three risk groups more accurately than the RCRI.
Conclusion:
The RCRI is not appropriate for peri-operative cardiovascular risk stratification in vascular surgery patients. The SAVS-CRI may be preferable for risk stratification in South African vascular surgery patients, although independent validation is required.
