Diagnosing Perioperative Cardiovascular Risks in Noncardiac Surgery Patients

Table 2

Analyses of cardiovascular risk index: comparison of National Surgical Quality Improvement Program and the Revised Cardiac Risk Index.

Criteria	National Surgical Quality Improvement Program	Revised Cardiac Risk Index
Interpretation	Elevated risk: 2 risk factors: 7% risk; ≥3 factors: 11% risk.; Low risk: 0 risk factors: 0.4% risk; 1 risk factor: 0.9% risk	Refer a percent risk from web-based calculator (http://www.qxmd.com/calculate/calculator_245/gupta-perioperative-cardiacrisk)
Factors used	History of ischemic heart disease, cerebrovascular disease, heart disease, serum creatinine level, diabetes level, condition of undergoing intrathoracic surgery	Serum creatinine ≥1.5 mg/dL; age; surgery type
Validation and derivation	Prospective cohort; single hospital	Historical national database; multicenter
Advantages of screening	Used for more than a decade	Surgery-specific
Disadvantages of screening	Functional capacity is not a variable; advanced procedures such as laparoscopy were not used; only 0.2% of patients had severe aortic stenosis	Aortic stenosis and coronary artery disease are not variables; due to the elevation of unknown significance, possibility of over diagnosing myocardial infarctions