[Preoperative risk evaluation in cardiac patients scheduled for vascular surgery].

Various methods and scales have been suggested to assess the risk of cardiac complications in patients who undergo major vascular surgery. Among them, the Vascular-POSSUM score, placed between the ASA and APACHE scales, combines risk factors associated with the clinical status of patients as wellas the extention and duration of surgery. The index is calculated after recording the following physiological parameters: age, selected cardiac and respiratory parameters, ECG, systolic blood pressure, pulse rate, haemoglobin, WBC, urea, sodium, potassium, and GCS. In the second part, procedural parameters are noted: the type of surgery, number of procedures, operative blood loss, malignancy status and CEPOD.The mortality/morbidity risk is calculated. Recently, assessment of b-type natriuretic peptide (NT-pro BNP test), which is a more powerful predictor of prognosis than the ejection fraction and other traditional outcome markers, has been proposed for assessment of perioperative risk.