Risk stratification for no cardiac surgery

Abstract

Over 234 million major non-cardiac surgeries are performed annually worldwide with an estimated mortality rate of 0.5–1.5%. Perioperative major adverse cardiac events (MACE) contribute up to one third of these complications leading to prolonged hospital stay, increased medical cost and perioperative deaths annually.¹ The definition of perioperative cardiac complications is not standardised, however in the revised cardiac risk index (RCRI), which has been used for over 20 years, it is defined as cardiac death, non-fatal cardiac arrest, myocardial infarction, pulmonary oedema and complete heart block.² Research has shown that perioperative outcomes depend on the patient’s premorbid state, the type of surgery and the circumstances under which the surgery took place. The mortality rate increases 1.5 times in patients diagnosed with coronary artery disease, heart failure, stroke and peripheral artery disease and by 2–5 times in emergency surgery.