BACKGROUND: Major adverse cardiac and cerebrovascular events (MACCE) represent the most common cause of serious perioperative morbidity and mortality. Our aim was to identify risk factors for MACCE in a broad surgical population with intermediate-to-high surgery-specific risk and to build and validate a model to predict the risk of MACCE. METHODS: A prospective, multicentre study of patients undergoing surgical procedures under general or regional anaesthesia in 23 hospitals. The main outcome was the occurrence of at least one perioperative MACCE, defined as any of the following complications from admittance to discharge: cardiac death, cerebrovascular death, non-fatal cardiac arrest, acute myocardial infarction, congestive heart failure, new cardiac arrhythmia, angina, or stroke. The MACCE predictive index was based on β-coefficients and validated in an external data set. RESULTS: Of 3387 patients recruited, 146 (4.3%) developed at least one MACCE. The regression model identified seven independent risk factors for MACCE: history of coronary artery disease, history of chronic congestive heart failure, chronic kidney disease, history of cerebrovascular disease, preoperative abnormal ECG, intraoperative hypotension, and blood transfusion. The area under the receiver-operating characteristic curve was 75.9% (95% confidence interval, 71.2-80.6%). CONCLUSIONS: The risk score based on seven objective and easily assessed factors can accurately predict MACCE occurrence after non-cardiac surgery in a population at intermediate-to-high surgery-specific risk.
BACKGROUND: Major adverse cardiac and cerebrovascular events (MACCE) represent the most common cause of serious perioperative morbidity and mortality. Our aim was to identify risk factors for MACCE in a broad surgical population with intermediate-to-high surgery-specific risk and to build and validate a model to predict the risk of MACCE. METHODS: A prospective, multicentre study of patients undergoing surgical procedures under general or regional anaesthesia in 23 hospitals. The main outcome was the occurrence of at least one perioperative MACCE, defined as any of the following complications from admittance to discharge: cardiac death, cerebrovascular death, non-fatal cardiac arrest, acute myocardial infarction, congestive heart failure, new cardiac arrhythmia, angina, or stroke. The MACCE predictive index was based on β-coefficients and validated in an external data set. RESULTS: Of 3387 patients recruited, 146 (4.3%) developed at least one MACCE. The regression model identified seven independent risk factors for MACCE: history of coronary artery disease, history of chronic congestive heart failure, chronic kidney disease, history of cerebrovascular disease, preoperative abnormal ECG, intraoperative hypotension, and blood transfusion. The area under the receiver-operating characteristic curve was 75.9% (95% confidence interval, 71.2-80.6%). CONCLUSIONS: The risk score based on seven objective and easily assessed factors can accurately predict MACCE occurrence after non-cardiac surgery in a population at intermediate-to-high surgery-specific risk.
Authors: Qingyi Zhang; Shijiu Yin; Kai Huang; Miye Wang; Huiqi Xie; Ren Liao; Yi Zeng; Jing Yang Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi Date: 2021-09-15
Authors: Michael E Lidsky; Paul J Speicher; Ryan S Turley; Andrew S Barbas; Bryan M Clary Journal: J Gastrointest Surg Date: 2014-01-17 Impact factor: 3.452
Authors: Lorraine Sazgary; Christian Puelacher; Giovanna Lurati Buse; Noemi Glarner; Andreas Lampart; Daniel Bolliger; Luzius Steiner; Lorenz Gürke; Thomas Wolff; Edin Mujagic; Stefan Schaeren; Didier Lardinois; Jacqueline Espinola; Christoph Kindler; Angelika Hammerer-Lercher; Ivo Strebel; Karin Wildi; Reka Hidvegi; Johanna Gueckel; Christina Hollenstein; Tobias Breidthardt; Katharina Rentsch; Andreas Buser; Danielle M Gualandro; Christian Mueller Journal: Eur Heart J Acute Cardiovasc Care Date: 2020-10-14