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Cardiac risk of noncardiac surgery
Akshar Y Patel1, Kim A Eagle1, Prashant Vaishnava1
1Department of Medicine, Samuel and Jean A. Frankel Cardiovascular Center, University of Michigan Health System and Medical School, Ann Arbor, Michigan.
Insights
Identifying patients at high risk for major cardiac events during surgery is crucial. This allows for better patient counseling, resource allocation, and targeted preventive strategies to improve surgical outcomes.
Area of Science:
- Cardiology
- Anesthesiology
- Perioperative Medicine
Background:
- Major perioperative cardiac events affect 1.4%–3.9% of surgeries.
- Elective surgeries offer opportunities for risk reduction strategies.
- Accurate risk assessment informs patient counseling and resource allocation.
Purpose of the Study:
- To review pre-operative clinical risk assessment for cardiac events.
- To outline indications for diagnostic testing to quantify cardiac risk.
- To discuss methods and indications for pre-emptive therapies.
Main Methods:
- Review of clinical risk assessment tools.
- Analysis of indications for cardiac diagnostic testing.
- Evaluation of pre-emptive therapeutic strategies.
Main Results:
- Pre-operative assessment identifies patients at risk.
- Diagnostic testing guides intervention decisions.
- Pre-emptive therapies can mitigate cardiac risk.
Conclusions:
- Optimizing pre-operative cardiac risk assessment is essential.
- Targeted diagnostic testing and pre-emptive therapies improve patient safety.
- This approach enhances perioperative care and resource utilization.
Abstract:
Major perioperative cardiac events are estimated to complicate between 1.4% and 3.9% of surgeries. Because most surgeries are elective, there is the opportunity to implement strategies to reduce this risk. Accurate identification of patients at risk for such events will allow patients to be better informed about the benefit-to-risk ratio of procedures, and guide allotment of limited clinical resources, utilization of preventive interventions, and areas of future research. This review focuses on important features of the initial pre-operative clinical risk assessment, indications for diagnostic testing to quantify cardiac risk, and the methods and indications for pre-emptive therapies.
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