Revised Cardiac Risk Index is an Effective Prognostic Tool for Vascular Postoperative Outcomes

Cho C, Lombardi JV, Gaughan J, Alexander JB, Trani JL, Carpenter JP and Caputo FJ

Division of Vascular & Endovascular Surgery, Cooper University Hospital, USA

^*Correspondance to: Francis J Caputo 

 PDF  Full Text DOI: 10.25107/2474-1647.1050

Abstract

Objectives: The Revised Cardiac Risk Index (RCRI) is a tool clinician’s use for preoperative risk stratification and predicting the likelihood of cardiac complications. This study looks at the role of the RCRI for postoperative outcomes in vascular patients undergoing lower extremity bypass surgery.Methods: National Surgical Quality Improvement Program (NSQIP) data from 2005-2011 of patients undergoing lower extremity revascularization based on CPT codes were analyzed looking at demographics, revised cardiac risk index variables (coronary heart disease, congestive heart failure, creatinine >2, insulin dependent diabetes, high-risk surgery, cerebrovascular disease), and outcomes including operative time, hospital length of stay (LOS), return to operating room, and death. Data was analyzed using single and multivariable linear and logistical regression.Results: 70,560 patients were included with 36% female and 64% male patients. Of these patients, 40,893 (58%) were over the age of 65 with 27,576 (39%) of the patients between the ages of 46 and 65. Using linear regression, with each unit increase of the RCRI, operative time increases 5.4 minutes (p<0.0001), and LOS increases 3.23 days (P<0.0001). Through logistic regression, with each unit increase in the RCRI the risk of returning to OR increases 1.4 times (OR=1.449; 95%CI 1.41-1.49) and the risk of death increases 1.97 times (OR =1.972; 95% CI 1.87-2.08). The risk of MI increased 1.6 times for each unit increase in RCRI (P<.0001).Conclusion: Using a large retrospective national database, preoperative RCRI can be a useful measure for predicting postoperative outcomes in patients undergoing lower extremity bypass surgery.

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Cite the article

Cho C, Lombardi JV, Gaughan J, Alexander JB, Trani JL, Carpenter JP, et al. Revised Cardiac Risk Index is an Effective Prognostic Tool for Vascular Postoperative Outcomes. Clin Surg. 2016; 1: 1050.