ACS NSQIP Surgical Risk Calculator and Lee and ACP/Detsky IRCR scores: preoperative cardiovascular assessment

Abstract

Introduction: preoperative and postoperative cardiac events are the major cause of morbidity and mortality in elective non-cardiac surgeries. Thus, preoperative cardiovascular risk stratification is essential to identify the risk and minimize its possible complications. Objective: to investigate the correlation between the ACS NSQIP Surgical Risk Calculator score and the traditionally used scores (ACP modified by Detsky and IRCR by Lee) in the preoperative outpatient assessment of cardiovascular risk in non-cardiac surgeries. Methods: Retrospective cross-sectional observational study with analysis of electronic records of patients seen at a multidisciplinary outpatient clinic of perioperative medicine and nursing in the period between January and December 2017. The cardiovascular risk score of Lee and ACP/Detsky already applied was correlated in the outpatient clinic with the cardiac risk obtained by the ACS NSQIP Surgical Risk Calculator. Results: A sample of 416 medical records was collected. Of these, 195 (47%) resulted in an equivalent risk between the two scores and 221 cases diverged in the results. A p<0.001 was obtained using the Wilcoxon test. Conclusions: There was a correlation between the ACS NSQIP Surgical Risk Calculator and the Lee and ACP/Detsky scores (p<0.001).