Mark K Ferguson1, Paramita Saha-Chaudhuri2, John D Mitchell3, Gonzalo Varela4, Alex Brunelli5. 1. Department of Surgery, The University of Chicago, Chicago, Illinois. Electronic address: mferguso@surgery.bsd.uchicago.edu. 2. Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina. 3. Department of Surgery, University of Colorado Denver School of Medicine, Denver, Colorado. 4. Department of Thoracic Surgery, Hospital Universitario de Salamanca, Salamanca, Spain. 5. Division of Thoracic Surgery, St. James's University Hospital, Leeds, UK.
Abstract
BACKGROUND: Cardiovascular complications occur in 10% to 15% of patients after major lung resection. We evaluated the utility of a revised scoring system (thoracic revised cardiac risk index; ThRCRI) in identifying patients at increased risk for major cardiovascular complications. METHODS: We analyzed outcomes from the Society of Thoracic Surgeons General Thoracic Database for the period 2003 to 2011 for elective major lung resection. The ThRCRI risk score was based on weighted values for serum creatinine, coronary artery disease, cerebrovascular disease, and extent of lung resection, and was stratified into the following 4 risk categories: 0 (A); 1 to 1.5 (B); 2 to 2.5 (C); and >2.5 (D). Major cardiovascular complications included myocardial infarction, adult respiratory distress syndrome, ventricular arrhythmia requiring treatment, and all-cause death. RESULTS: A total of 26,085 patients (mean age 65.4±11.4 years; 51.3% men) underwent lobectomy (21,679; 83.2%), bilobectomy (1,446; 5.5%) or pneumonectomy (1,697; 6.5%). Major cardiovascular complications occurred in 1,125 patients (4.3%). ThRCRI scores in patients without and with major cardiovascular complications were 0.6±0.9 and 1.1±1.1 (p<0.0001). Score categories yielded incremental risks of major cardiovascular complications (A: 2.9%; B: 5.8%; C: 11.9%; D: 11.1%; p<0.0001). CONCLUSIONS: The ThRCRI score stratified risk moderately well for major postoperative cardiovascular events after major lung resection. Use of this scoring system might help in identifying patients who would benefit from additional preoperative evaluation and from closer perioperative monitoring.
BACKGROUND:Cardiovascular complications occur in 10% to 15% of patients after major lung resection. We evaluated the utility of a revised scoring system (thoracic revised cardiac risk index; ThRCRI) in identifying patients at increased risk for major cardiovascular complications. METHODS: We analyzed outcomes from the Society of Thoracic Surgeons General Thoracic Database for the period 2003 to 2011 for elective major lung resection. The ThRCRI risk score was based on weighted values for serum creatinine, coronary artery disease, cerebrovascular disease, and extent of lung resection, and was stratified into the following 4 risk categories: 0 (A); 1 to 1.5 (B); 2 to 2.5 (C); and >2.5 (D). Major cardiovascular complications included myocardial infarction, adult respiratory distress syndrome, ventricular arrhythmia requiring treatment, and all-cause death. RESULTS: A total of 26,085 patients (mean age 65.4±11.4 years; 51.3% men) underwent lobectomy (21,679; 83.2%), bilobectomy (1,446; 5.5%) or pneumonectomy (1,697; 6.5%). Major cardiovascular complications occurred in 1,125 patients (4.3%). ThRCRI scores in patients without and with major cardiovascular complications were 0.6±0.9 and 1.1±1.1 (p<0.0001). Score categories yielded incremental risks of major cardiovascular complications (A: 2.9%; B: 5.8%; C: 11.9%; D: 11.1%; p<0.0001). CONCLUSIONS: The ThRCRI score stratified risk moderately well for major postoperative cardiovascular events after major lung resection. Use of this scoring system might help in identifying patients who would benefit from additional preoperative evaluation and from closer perioperative monitoring.
Authors: Takashi Eguchi; Sarina Bains; Ming-Ching Lee; Kay See Tan; Boris Hristov; Daniel H Buitrago; Manjit S Bains; Robert J Downey; James Huang; James M Isbell; Bernard J Park; Valerie W Rusch; David R Jones; Prasad S Adusumilli Journal: J Clin Oncol Date: 2016-10-31 Impact factor: 44.544
Authors: Maren E Shipe; Amelia W Maiga; Stephen A Deppen; Gretchen C Edwards; Hannah N Marmor; Rhonda Pinkerman; Gary T Smith; Elizabeth Lio; Johnny L Wright; Chirayu Shah; Jonathan C Nesbitt; Eric L Grogan Journal: J Thorac Dis Date: 2021-03 Impact factor: 2.895
Authors: Andrej Mazur; Kristian Brat; Pavel Homolka; Zdenek Merta; Michal Svoboda; Monika Bratova; Vladimir Sramek; Lyle J Olson; Ivan Cundrle Journal: PLoS One Date: 2022-08-12 Impact factor: 3.752