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Preoperative Estimation of Risk in Cardiac Surgery

Jorge Urzua, MD^*, Pelusa Dominguez, MD, Martita Quiroga, MD, Sergio Moran, MD, Manuel Irarrazaval, MD, Gustavo Maturana, MD, and Juan Dubernet, MD

*Associate Professor of Anesthesiology. Departments of Anesthesiology and Cardiovascular Diseases, Catholic University of Chile, School of Medicine, Santiago, Chile. Instructor of Anesthesiology. Departments of Anesthesiology and Cardiovascular Diseases, Catholic University of Chile, School of Medicine, Santiago, Chile. Assistant Professor of Surgery. Departments of Anesthesiology and Cardiovascular Diseases, Catholic University of Chile, School of Medicine, Santiago, Chile. Professor of Surgery. Departments of Anesthesiology and Cardiovascular Diseases, Catholic University of Chile, School of Medicine, Santiago, Chile.

Abstract

In order to determine the usefulness of the preoperative subjective estimation of risk and to compare it with preoperative estimation of risk based upon objective data, two groups of patients subjected to open heart surgery at the Catholic University of Chile Clinical Hospital were studied prospectively. Group I comprised 227 consecutive patients operated on in 1975 and group II comprised 181 consecutive patients operated on in 1979. There were several important differences in management and techniques between the two groups, which resulted in different factors for perioperative mortality. Mortality in group I was related to extreme age subsets (p < 0.01) and to duration of anoxic arrest (p < 0.001); mortality in group II correlated only to preoperative functional class (NYHA) (p < 0.02). Despite these differences, subjective risk estimation as preoperatively recorded by the anesthesiologist was accurate in both groups (r = 0.969, p < 0.05 in group I and r = 0.998, p < 0.01 in group II). It was concluded that in the absence of a universally valid objective risk index, subjective risk estimation provides a clinical index as useful as reliance upon presently available objective data.

Key Words: RISK: estimate • ANESTHESIA: cardiovascular • SURGERY: cardiovascular

This article has been cited by other articles:

				J. M.V. Pons, J. M. Borras, J. A. Espinas, V. Moreno, M. Cardona, and A. Granados Subjective versus statistical model assessment of mortality risk in open heart surgical procedures Ann. Thorac. Surg., March 1, 1999; 67(3): 635 - 640. [Abstract] [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999