Best Practice & Research Clinical Anaesthesiology
Volume 22, Issue 1 , Pages 1-21 , March 2008

Risk stratification

  • William Vernick, MD (Assistant Professor of Anesthesiology & Critical Care)

      Affiliations

    • Corresponding Author InformationCorresponding author.
  • ,
  • Lee A. Fleisher, MD, FACC, FAHA (Robert D. Dripps Professor and Chair of Anesthesiology & Critical Care, Professor of Medicine)

References 

  1. Mangano DT, Browner WS, Hollenberg M, et al. Association of perioperative myocardial ischemia with cardiac morbidity and mortality in men undergoing noncardiac surgery. The Study of Perioperative Ischemia Research Group. New England Journal of Medicine. 1990;323(26):1781–1788
  2. Khuri SF, Daley J, Henderson W, et al. The National Veterans Administration Surgical Risk Study: risk adjustment for the comparative assessment of the quality of surgical care. Journal of the American College of Surgeons. 1995;180(5):519–531
  3. Lee TH, Marcantonio ER, Mangione CM, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation. 1999;100(10):1043–1049
  4. Poldermans D, Boersma E, Bax JJ, et al. The effect of bisoprolol on perioperative mortality and myocardial infarction in high-risk patients undergoing vascular surgery. Dutch Echocardiographic Cardiac Risk Evaluation Applying Stress Echocardiography Study Group. New England Journal of Medicine. 1999;341(24):1789–1794
  5. Devereaux PJ, Goldman L, Cook DJ, et al. Perioperative cardiac events in patients undergoing noncardiac surgery: a review of the magnitude of the problem, the pathophysiology of the events and methods to estimate and communicate risk. Canadian Medical Association Journal. 2005;173(6):627–634
  6. Fleischmann KE, Goldman L, Young B, Lee TH. Association between cardiac and noncardiac complications in patients undergoing noncardiac surgery: outcomes and effects on length of stay. American Journal of Medicine. 2003;115(7):515–520
  7. Fleisher LA, Corbett W, Berry C, Poldermans D. Cost-effectiveness of differing perioperative beta-blockade strategies in vascular surgery patients. Journal of Cardiothoracic and Vascular Anesthesia. 2004;18(1):7–13
  8. Keats AS. The ASA classification of physical status – a recapitulation. Anesthesiology. 1978;49(4):233–236
  9. Menke H, Klein A, John KD, Junginger T. Predictive value of ASA classification for the assessment of the perioperative risk. International Surgery. 1993;78(3):266–270
  10. Goldman L, Caldera DL, Nussbaum SR, et al. Multifactorial index of cardiac risk in noncardiac surgical procedures. New England Journal of Medicine. 1977;297(16):845–850
  11. Warner MA, Shields SE, Chute CG. Major morbidity and mortality within 1 month of ambulatory surgery and anesthesia. Journal of the American Medical Association. 1993;270(12):1437–1441
  12. Backer CL, Tinker JH, Robertson DM, Vlietstra RE. Myocardial reinfarction following local anesthesia for ophthalmic surgery. Anesthesia and Analgesia. 1980;59(4):257–262
  13. Steen PA, Tinker JH, Tarhan S. Myocardial reinfarction after anesthesia and surgery. Journal of the American Medical Association. 1978;239(24):2566–2570
  14. Detsky AS, Abrams HB, McLaughlin JR, et al. Predicting cardiac complications in patients undergoing non-cardiac surgery. Journal of General Internal Medicine. 1986;1(4):211–219
  15. Kumar R, McKinney WP, Raj G, et al. Adverse cardiac events after surgery: assessing risk in a veteran population. Journal of General Internal Medicine. 2001;16(8):507–518
  16. Palda VA, Detsky AS. Perioperative assessment and management of risk from coronary artery disease. Annals of Internal Medicine. 1997;127(4):313–328
  17. Eagle KA, Coley CM, Newell JB, et al. Combining clinical and thallium data optimizes preoperative assessment of cardiac risk before major vascular surgery. Annals of Internal Medicine. 1989;110(11):859–866
  18. Jeffrey CC, Kunsman J, Cullen DJ, Brewster DC. A prospective evaluation of cardiac risk index. Anesthesiology. 1983;58(5):462–464
  19. Hlatky MA, Boineau RE, Higginbotham MB, et al. A brief self-administered questionnaire to determine functional capacity (the Duke Activity Status Index). American Journal of Cardiology. 1989;64(10):651–654
  20. Reilly DF, McNeely MJ, Doerner D, et al. Self-reported exercise tolerance and the risk of serious perioperative complications. Archives of Internal Medicine. 1999;159(18):2185–2192
  21. Girish M, Trayner E, Dammann O, et al. Symptom-limited stair climbing as a predictor of postoperative cardiopulmonary complications after high-risk surgery. Chest. 2001;120(4):1147–1151
  22. Browner WS, Li J, Mangano DT. In-hospital and long-term mortality in male veterans following noncardiac surgery. The Study of Perioperative Ischemia Research Group. Journal of the American Medical Association. 1992;268(2):228–232
  23. Gilbert K, Larocque BJ, Patrick LT. Prospective evaluation of cardiac risk indices for patients undergoing noncardiac surgery. Annals of Internal Medicine. 2000;133(5):356–359
  24. Boersma E, Poldermans D, Bax JJ, et al. Predictors of cardiac events after major vascular surgery: role of clinical characteristics, dobutamine echocardiography, and beta-blocker therapy. Journal of the American Medical Association. 2001;285(14):1865–1873
  25. Eagle KA, Brundage BH, Chaitman BR, et al. Guidelines for perioperative cardiovascular evaluation for noncardiac surgery. Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Committee on Perioperative Cardiovascular Evaluation for Noncardiac Surgery. Circulation. 1996;93(6):1278–1317
  26. Eagle KA, Berger PB, Calkins H, et al. ACC/AHA guideline update for perioperative cardiovascular evaluation for noncardiac surgery – executive summary a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1996 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). Circulation. 2002;105(10):1257–1267
  27. Shaw LJ, Eagle KA, Gersh BJ, Miller DD. Meta-analysis of intravenous dipyridamole-thallium-201 imaging (1985 to 1994) and dobutamine echocardiography (1991 to 1994) for risk stratification before vascular surgery. Journal of the American College of Cardiology. 1996;27(4):787–798
  28. Kertai MD, Boersma E, Sicari R, et al. Which stress test is superior for perioperative cardiac risk stratification in patients undergoing major vascular surgery?. European Journal ofVascular and Endovascular Surgery. 2002;24(3):222–229
  29. Beattie WS, Abdelnaem E, Wijeysundera DN, Buckley DN. A meta-analytic comparison of preoperative stress echocardiography and nuclear scintigraphy imaging. Anesthesia and Analgesia. 2006;102(1):8–16
  30. Etchells E, Meade M, Tomlinson G, Cook D. Semiquantitative dipyridamole myocardial stress perfusion imaging for cardiac risk assessment before noncardiac vascular surgery: a meta-analysis. Journal of Vascular Surgery. 2002;36(3):534–540
  31. Chassot PG, Delabays A, Spahn DR. Preoperative evaluation of patients with, or at risk of, coronary artery disease undergoing non-cardiac surgery. British Journal of Anaesthesia. 2002;89(5):747–759
  32. Mason JJ, Owens DK, Harris RA, et al. The role of coronary angiography and coronary revascularization before noncardiac vascular surgery. Journal of the American Medical Association. 1995;273(24):1919–1925
  33. Poldermans D, Bax JJ, Schouten O, et al. Should major vascular surgery be delayed because of preoperative cardiac testing in intermediate-risk patients receiving beta-blocker therapy with tight heart rate control?. Journal of the American College of Cardiology. 2006;48(5):964–969
  34. Park KW, Subramaniam K, Mahmood F, et al. Patients with positive preoperative stress tests undergoing vascular surgery. Journal of Cardiothoracic and Vascular Anesthesia. 2005;19(4):494–498
  35. Falcone RA, Nass C, Jermyn R, et al. The value of preoperative pharmacologic stress testing before vascular surgery using ACC/AHA guidelines: a prospective, randomized trial. Journal of Cardiothoracic and Vascular Anesthesia. 2003;17(6):694–698
  36. McFalls EO, Ward HB, Moritz TE, et al. Coronary-artery revascularization before elective major vascular surgery. New England Journal of Medicine. 2004;351(27):2795–2804
  37. Kaluza GL, Joseph J, Lee JR, et al. Catastrophic outcomes of noncardiac surgery soon after coronary stenting. Journal of the American College of Cardiology. 2000;35(5):1288–1294
  38. Sharma AK, Ajani AE, Hamwi SM, et al. Major noncardiac surgery following coronary stenting: when is it safe to operate?. Catheterization and Cardiovascular Interventions. 2004;63(2):141–145
  39. Cutlip DE, Baim DS, Ho KK, et al. Stent thrombosis in the modern era: a pooled analysis of multicenter coronary stent clinical trials. Circulation. 2001;103(15):1967–1971
  40. Grines CL, Bonow RO, Casey DE, et al. Prevention of premature discontinuation of dual antiplatelet therapy in patients with coronary artery stents: a science advisory from the American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons, and American Dental Association, with representation from the American College of Physicians. Journal of the American College of Cardiology. 2007;49(6):734–739
  41. Ward HB, Kelly RF, Thottapurathu L, et al. Coronary artery bypass grafting is superior to percutaneous coronary intervention in prevention of perioperative myocardial infarctions during subsequent vascular surgery. Annals of Thoracic Surgery. 2006;82(3):795–800
  42. Moscucci M, Jones N. Coronary revascularization before noncardiac vascular surgery: one more step forward in understanding its role. Journal of the American College of Cardiology. 2007;49(17):1770–1771
  43. Eagle KA, Guyton RA, Davidoff R, et al. ACC/AHA 2004 guideline update for coronary artery bypass graft surgery: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1999 Guidelines for Coronary Artery Bypass Graft Surgery). Journal of the American College of Cardiology. 2004;44(5):e213–e310
  44. Smith SC, Feldman TE, Hirshfeld JW, et al. ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention – summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/SCAI Writing Committee to update the 2001 Guidelines for Percutaneous Coronary Intervention). Catheterization and Cardiovascular Interventions. 2006;67(1):87–112
  45. Foster ED, Davis KB, Carpenter JA, et al. Risk of noncardiac operation in patients with defined coronary disease: The Coronary Artery Surgery Study (CASS) registry experience. Annals of Thoracic Surgery. 1986;41(1):42–50
  46. Hassan SA, Hlatky MA, Boothroyd DB, et al. Outcomes of noncardiac surgery after coronary bypass surgery or coronary angioplasty in the Bypass Angioplasty Revascularization Investigation (BARI). American Journal of Medicine. 2001;110(4):260–266
  47. McFalls EO, Ward HB. Coronary revascularization before vascular surgery (authors reply). New England Journal of Medicine. 2005;352(14):1492–1495
  48. Landesberg G, Mosseri M, Wolf YG, et al. Preoperative thallium scanning, selective coronary revascularization, and long-term survival after major vascular surgery. Circulation. 2003;108(2):177–183
  49. Landesberg G, Berlatzky Y, Bocher M, et al. A clinical survival score predicts the likelihood to benefit from preoperative thallium scanning and coronary revascularization before major vascular surgery. European Heart Journal. 2007;28(5):533–539
  50. Landesberg G, Mosseri M, Shatz V, et al. Cardiac troponin after major vascular surgery: the role of perioperative ischemia, preoperative thallium scanning, and coronary revascularization. Journal of the American College of Cardiology. 2004;44(3):569–575
  51. Landesberg G, Shatz V, Akopnik I, et al. Association of cardiac troponin, CK-MB, and postoperative myocardial ischemia with long-term survival after major vascular surgery. Journal of the American College of Cardiology. 2003;42(9):1547–1554
  52. Poldermans D, Schouten O, Vidakovic R, et al. A clinical randomized trial to evaluate the safety of a noninvasive approach in high-risk patients undergoing major vascular surgery: the DECREASE-V Pilot Study. Journal of the American College of Cardiology. 2007;49(17):1763–1769
  53. Burger W, Chemnitius JM, Kneissl GD, Rucker G. Low-dose aspirin for secondary cardiovascular prevention – cardiovascular risks after its perioperative withdrawal versus bleeding risks with its continuation – review and meta-analysis. Journal of Internal Medicine. 2005;257(5):399–414
  54. Durazzo AE, Machado FS, Ikeoka DT, et al. Reduction in cardiovascular events after vascular surgery with atorvastatin: a randomized trial. Journal of Vascular Surgery. 2004;39(5):967–975
  55. Schouten O, Poldermans D, Visser L, et al. Fluvastatin and bisoprolol for the reduction of perioperative cardiac mortality and morbidity in high-risk patients undergoing non-cardiac surgery: rationale and design of the DECREASE-IV study. American Heart Journal. 2004;148(6):1047–1105
  56. Kertai MD, Boersma E, Bax JJ, et al. Optimizing long-term cardiac management after major vascular surgery: Role of beta-blocker therapy, clinical characteristics, and dobutamine stress echocardiography to optimize long-term cardiac management after major vascular surgery. Archives of Internal Medicine. 2003;163(18):2230–2235
  57. Paul SD, Eagle KA, Kuntz KM, et al. Concordance of preoperative clinical risk with angiographic severity of coronary artery disease in patients undergoing vascular surgery. Circulation. 1996;94(7):1561–1566
  58. Wesorick DH, Eagle KA. The preoperative cardiovascular evaluation of the intermediate-risk patient: new data, changing strategies. American Journal of Medicine. 2005;118(12):1413
  59. Fleisher LA, Beckman JA, Brown KA, et al. ACC/AHA 2006 guideline update on perioperative cardiovascular evaluation for noncardiac surgery: focused update on perioperative beta-blocker therapy: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery): developed in collaboration with the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society for Vascular Medicine and Biology. Circulation. 2006;113(22):2662–2674
  60. Gibbons RJ, Abrams J, Chatterjee K, et al. ACC/AHA 2002 guideline update for the management of patients with chronic stable angina – summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Chronic Stable Angina). Circulation. 2003;107(1):149–158
  61. Devereaux PJ, Beattie WS, Choi PT, et al. How strong is the evidence for the use of perioperative beta blockers in non-cardiac surgery? Systematic review and meta-analysis of randomised controlled trials. BMJ. 2005;331(7512):313–321
  62. Fleisher LA, Beckman JA, Brown KA, et al. ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery) developed in collaboration with the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and Society for Vascular Surgery [erratum appears in J Am Coll Cardiol 2007 Oct 23;50(17):e242] [Journal Article. Practice Guideline]. Journal of the American College of Cardiology. 2007 Oct 23;50(17):e159–e241

PII: S1521-6896(07)00090-0

doi: 10.1016/j.bpa.2007.10.002

Best Practice & Research Clinical Anaesthesiology
Volume 22, Issue 1 , Pages 1-21 , March 2008