Major Perioperative Cardiac Risk Assessment: A Review for Cardio-Oncologists and Perioperative Physicians

Area of Science:

• Cardiology
• Surgical Oncology
• Health Services Research

Background:

• The Revised Cardiac Risk Index (RCRI) and American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) are standard tools for perioperative cardiac risk assessment.
• These tools aim for broad applicability in noncardiac surgery but may lack precision for specific patient groups.

Purpose of the Study:

• To evaluate the reliability of RCRI and ACS NSQIP risk assessment tools in diverse surgical oncology patient populations.
• To identify specific subpopulations within surgical oncology where these tools demonstrate poor predictive accuracy.

Main Methods:

• Review of existing literature on the application of RCRI and ACS NSQIP in surgical oncology.
• Analysis of studies comparing the predictive performance of these tools across different cancer types and surgical procedures.

Main Results:

• The RCRI and ACS NSQIP tools show variable reliability in surgical oncology patients.
• Certain patient subgroups, such as those undergoing complex oncologic resections, may experience less accurate risk prediction.

Conclusions:

• While widely used, the RCRI and ACS NSQIP tools require careful consideration of their limitations in surgical oncology.
• Further research is needed to refine risk assessment models for improved accuracy in cancer patients undergoing noncardiac surgery.