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Am J Surg. 2004 Nov;188(5):495-9.

Thirty-day and one-year predictors of death in noncardiac major surgical procedures.

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1
Michael E. DeBakey Veteran Affairs Medical Center and Department of Surgery, Baylor College of Medicine, Houston, TX, USA.

Abstract

BACKGROUND:

We evaluated the predictive value of the American College of Cardiology/American Heart Association (ACC/AHA) cardiac risk classification, as well as other potential risk factors (procedure risk, smoking, obesity, hyperlipidemia, and renal insufficiency), on all-cause mortality at 30 days and at 1 year postoperatively.

METHODS:

In the year 2000, 1238 consecutive patients undergoing general anesthesia for various noncardiac surgical procedures at the Houston Veterans Affairs Medical Center were screened preoperatively and classified according to the ACC/AHA guidelines. Patients' charts were reviewed for the above-mentioned risk factors.

RESULTS:

A logistic regression analysis demonstrated that older age and higher procedure risk were associated with higher 30-day mortalities (P = 0.0012 and 0.0441, respectively). The ACC/AHA classification was positively correlated with mortality at 1 year (P = 0.0071).

CONCLUSIONS:

The ACC/AHA classification predicts mortality at 1 year but not at 30 days for major noncardiac surgeries; procedure-related risk is a better predictor of 30-day postoperative mortality in our patient population.

PMID:
15546557
DOI:
10.1016/j.amjsurg.2004.07.018
[Indexed for MEDLINE]
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