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Published in: Journal of Cardiothoracic Surgery 1/2013

Open Access 01-12-2013 | Research article

Does the revised cardiac risk index predict cardiac complications following elective lung resection?

Authors: Robin Wotton, Andrea Marshall, Amy Kerr, Ehab Bishay, Maninder Kalkat, Pala Rajesh, Richard Steyn, Babu Naidu

Published in: Journal of Cardiothoracic Surgery | Issue 1/2013

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Abstract

Background

Revised Cardiac Risk Index (RCRI) score and Thoracic Revised Cardiac Risk Index (ThRCRI) score were developed to predict the risks of postoperative major cardiac complications in generic surgical population and thoracic surgery respectively. This study aims to determine the accuracy of these scores in predicting the risk of developing cardiac complications including atrial arrhythmias after lung resection surgery in adults.

Methods

We studied 703 patients undergoing lung resection surgery in a tertiary thoracic surgery centre. Observed outcome measures of postoperative cardiac morbidity and mortality were compared against those predicted by risk.

Results

Postoperative major cardiac complications and supraventricular arrhythmias occurred in 4.8% of patients. Both index scores had poor discriminative ability for predicting postoperative cardiac complications with an area under receiver operating characteristic (ROC) curve of 0.59 (95% CI 0.51-0.67) for the RCRI score and 0.57 (95% CI 0.49-0.66) for the ThRCRI score.

Conclusions

In our cohort, RCRI and ThRCRI scores failed to accurately predict the risk of cardiac complications in patients undergoing elective resection of lung cancer. The British Thoracic Society (BTS) recommendation to seek a cardiology referral for all asymptomatic pre-operative lung resection patients with > 3 RCRI risk factors is thus unlikely to be of clinical benefit.
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Metadata
Title
Does the revised cardiac risk index predict cardiac complications following elective lung resection?
Authors
Robin Wotton
Andrea Marshall
Amy Kerr
Ehab Bishay
Maninder Kalkat
Pala Rajesh
Richard Steyn
Babu Naidu
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2013
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/1749-8090-8-220

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