Abstract 16476: Usefulness of Our New Patient Screening System by Using Functional Capacity Based on the Aha Guideline, for Non-cardiac Surgery Candidates
Introduction: We developed a new cardiovascular screening system “Cardiac Preparative Screening (CPS)” which is used to evaluate the needs of cardiac consultant for the patients who are planned for non-cardiac surgeries. This system was created from slightly modified version of the ACC/AHA guideline for non-cardiac surgery 2007. Purpose of this study is to evaluate the usefulness of this system.
Methods: A total of 6001 consecutive adult patients (2674 male, age 57±17 y/o) who underwent planned non-cardiac surgery in our hospital from August 2013 to December 2014 were evaluated in advance to the planned surgery. Patients were asked about the presence of active cardiac diseases, exercise capacity (measured in METS; metabolic equivalents) and clinical risk factors , then they were classified into 4 categories from C4 to C1 (as in figure); C4 (active cardiac diseases), C3 (<4METS and clinical risk factors ≥1), C2 (<4METS and no clinical risk factors),C1 (≥4METS), and. In CPS, C4 and C3 group should have cardiac consultants and C2 and C1 group could undergo surgery without any consultants.
Results: This system was performed in 4833 cases (80.5%) out of 6055 cases, CPS, C4: 151 cases, C3: 177, C2: 230, C1: 4275. Out of these, 709 cases (14.7%) were consulted to cardiologist. Among the 4833 evaluated patients 47 (0.96%) had cardiovascular events during and/or post-surgery; 6 ischemic events occurred (3 Variant angina, 2 AMI and 1 stable angina),18 atrial fibrillation, 11 PE/DVT, 4 hypertension, 8 others. There was no significant difference in the event-ratio (0.88% vs.1.97%, ns) between C1 and C2 “Low-risk” group and C3 and C4 “High-risk” group. Event-ratio was higher in elder patients group (≥61 y/o) than in younger group (1.53% vs. 0.40%, p<0.001).
Conclusions: This study proved that our new system (CPS) is simple and effective for evaluating the non-cardiac surgery candidates with either high or low cardiovascular event-risk.
Author Disclosures: S. Taniai: None. M.Y. Finger: None. T. Satoh: None. H. Yoshino: None.
- © 2016 by American Heart Association, Inc.