Document Detail


Risk stratification.
MedLine Citation:
PMID:  18494386     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Perioperative cardiac complications pose the greatest risk to the estimated 100 million people undergoing non-cardiac surgery each year. Most of these complications are related to underlying pre-existing coronary artery disease (CAD). For over 40 years researchers have been studying perioperative cardiac risk and how best to estimate it. The goal of improved risk stratification is important for allowing accurate informed decision-making, both by the patient and their physicians. Risk stratification has taken on an important role in clinical decision-making, helping physicians decide in which patients additional medical therapies, such as coronary revascularization or perioperative beta-blockers, are necessary. Meta-analysis has found a significant improvement in the positive predictive value (PPV) for perioperative cardiac outcome with stress testing over that with clinical risk score alone. However, evidence is mounting that with the use of perioperative beta-blockers, the majority of intermediate and high-risk patients can safely undergo even major vascular surgery without further cardiac testing.
Authors:
William Vernick; Lee A Fleisher
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Best practice & research. Clinical anaesthesiology     Volume:  22     ISSN:  1521-6896     ISO Abbreviation:  Best Pract Res Clin Anaesthesiol     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-05-22     Completed Date:  2008-08-07     Revised Date:  2011-04-28    
Medline Journal Info:
Nlm Unique ID:  101121446     Medline TA:  Best Pract Res Clin Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1-21     Citation Subset:  IM    
Affiliation:
University of Pennsylvania, Philadelphia, PA 19104, USA. vernickw@uphs.upenn.edu
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Clinical Trials as Topic
Coronary Artery Disease / mortality,  prevention & control*,  therapy
Decision Making
Electrocardiography
Exercise Test
Humans
Intraoperative Complications / mortality,  prevention & control*,  therapy
Perioperative Care / methods*
Postoperative Complications / mortality,  prevention & control*
Predictive Value of Tests
Risk Assessment / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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