Thirty-day and one-year predictors of death in noncardiac major surgical procedures |
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Authors: | Kaafarani Haytham M A Itani Kamal M F Thornby Jack Berger David H |
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Institution: | Michael E. DeBakey Veteran Affairs Medical Center and Department of Surgery, Baylor College of Medicine, Houston, TX, USA. |
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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. |
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Keywords: | Operative surgical procedure Risk factors Death Mortality Mortality determinant Cardiac risk classification Obesity Smoking Hyperlipidemia Renal insufficiency |
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