CJA
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text (PDF)
Right arrow Submit a scholarly reply
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by PAIEMENT, B.
Right arrow Articles by DUPONT, E.
Right arrow Search for Related Content
PubMed
Right arrow Articles by PAIEMENT, B.
Right arrow Articles by DUPONT, E.

Canadian Journal of Anesthesia, Vol 30, 61-68, Copyright © 1983 by Canadian Anesthesiologists' Society

Clinical Reports: A Simple Classification of the Risk in Cardiac Surgery

B. PAIEMENT MD1, C. PELLETIER MD1, I. DYRDA MD1, J. G. MAILLÉ MD1, M. BOULANGER MD1, J. TAILLEFER MD1, P. SAHAB MD1, M. DELORME MD1, and E. DUPONT MD1

1 Departments of Anaesthesiology, Surgery and Medicine, Montreal Heart Institute and University of Montreal

Address for Correspondence: Bernard Paiement MD, Anaesthesiology Department, Montreal Heart Institute, 5000 Bélanger Street East, Montréal, Québec H1T 1C8.

A new risk classification for patients undergoing cardiac surgery has been used for the last two years by the anaesthesiologists of the Montreal Heart Institute. The following factors known to be associated with a greater operative morbidity and mortality were selected: (1) poor left ventricular function, (2) congestive heart failure, (3) unstable angina or recent (less than 6 weeks) myocardial infarction, (4) age over 65 years, (5) severe obesity (Body Mass Index > 30), (6) reoperation, (7) emergency surgery, (8) other significant or uncontrolled systemic disturbances. Patients with none of the above factors were classified as normal risks; those presenting with one of those selected factors were classified as increased risks, and those with more than one factor were said to carry a high risk.

In a prospective study of 500 consecutive open-heart surgery patients classified according to this method, we found that the operated population at normal risk (50 per cent of cases) had a mortality of 0.4 per cent, the patient group with increased risk (32 per cent of cases) had a mortality of 3.1 per cent, and the high risk group (18 per cent of cases) had a 12.2 per cent mortality. Furthermore, SO deaths following open-heart surgery were assessed retrospectively using the classification; 58 per cent of these patients were classified as high risk, 34 per cent had an increased risk, and only eight per cent were found to be in the normal risk group. Thus, this new risk classification has proven to be a reliable and useful tool for preoperative assessment of patients undergoing open-heart surgery and for teaching purposes.

Key Words: RISK: estimate • ANAESTHESIA: cardiovascular • SURGERY: cardiovascular






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1983 by the Canadian Anesthesiologists' Society.