| Validation of a modified scoring system for cardiovascular risk associated with major lung resection. | |
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MedLine Citation:
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PMID: 22345181 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVES The well-known revised cardiac risk index (RCRI) has recently been modified based on factors and outcomes specific to thoracic surgery patients (ThRCRI). We explored the accuracy of this modified scoring system in predicting cardiovascular morbidity after major lung resection. METHODS We analyzed outcomes from a prospective database of patients undergoing major lung resection 1980-2009. ThRCRI score was based on weighted factors for serum creatinine, coronary artery disease, cerebrovascular disease and extent of lung resection. Target adverse outcomes included pulmonary embolism, myocardial infarction, cardiac arrest, pulmonary edema and cardiac death. RESULTS A total of 1255 patients (mean age 61.8 years; 649 men) underwent lobectomy or bilobectomy (1070; 85%) or pneumonectomy (185; 15%) for cancer (1037; 83%) or other problems. Severe cardiovascular complications occurred in 30 patients (2.4%), an incidence similar to that in the published derivation group (3.3%). ThRCRI median scores in patients without and with severe CV complications were 0 and 1.5 (P < 0.001). Score categories yielded incremental risks of cardiovascular complications (0: 0.9%; 1-1.5: 4.5%; ≥2: 12.8%; P < 0.001). The Hosmer-Lemeshow test demonstrated no significant difference between expected and observed outcomes (P = 0.11). CONCLUSIONS The incidences of severe postoperative cardiovascular complications were similar in the published derivation group and the current validation group. The ThRCRI score successfully stratified risk for postoperative cardiovascular events after major lung resection in the validation group. The expected risk in the validation group was similar to the observed risk, indicating that ThRCRI accurately predicted specific risk rather than just relative risk. Further evaluation of the utility of this scoring system is warranted. |
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Authors:
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Mark K Ferguson; Amy D Celauro; Wickii T Vigneswaran |
Publication Detail:
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Type: Journal Article Date: 2011-12-01 |
Journal Detail:
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Title: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery Volume: 41 ISSN: 1873-734X ISO Abbreviation: Eur J Cardiothorac Surg Publication Date: 2012 Mar |
Date Detail:
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Created Date: 2012-02-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8804069 Medline TA: Eur J Cardiothorac Surg Country: Germany |
Other Details:
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Languages: eng Pagination: 598-602 Citation Subset: IM |
Affiliation:
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Department of Surgery, The University of Chicago, Chicago, IL, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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