Original articleGeneral thoracicRecalibration of the Revised Cardiac Risk Index in Lung Resection Candidates
Section snippets
Patients and Methods
This is an observational study performed on prospectively collected data in two dedicated thoracic surgery centers. The study was approved by the local hospital institutional review boards, and patients gave their consent to collection and use of their data in the database for clinical and scientific purposes.
All 1,696 major lung resections (1,426 pulmonary lobectomies and 270 pneumonectomies) performed from January 2000 through December 2008 for benign, primary malignant, or metastatic disease
Results
The characteristics of the patients in this study are displayed in Table 1. There were 69 major cardiac complications in 57 patients (cumulative incidence, 3.3%): 36 pulmonary edema, 11 acute myocardial infarctions, 6 cardiac arrests, and 16 cardiac-related deaths (of 48 total deaths).
Logistic regression showed that only four of the six variables present in the original RCRI were reliably associated with major cardiac complications in this setting (Table 2).
According to their regression
Comment
Recently published guidelines from international medical and surgical societies have recommended the use of cardiac risk scores as screening tools for stratifying the cardiac risk of patients undergoing noncardiac surgery. The European Respiratory Society/European Society of Thoracic Surgeons task force for evaluating fitness of lung resection candidates with lung cancer recommended the application of the RCRI [4] in this setting. An RCRI lower than 2 has been reported to be associated with a
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