Risk assessment in coronary patients undergoing abdominal nonvascular surgery

The aim of our study was to establish that the incidence of perioperative cardiac complications were in direct correlation with level of operative risk in coronary patients undergoing open abdominal nonvascular surgery with general anesthesia. Our prospective observational clinical study was composed of a group of 111 consecutive patients with angiographically-verified coronary artery disease, who were operated on at the University Clinical Center of Serbia. The patients were classified into four stratification subgroups by “Goldman’s Cardiac Risk Index” (CRI) in relation to the incidence of perioperative cardiac complications. Electrocardiography was performed immediately after surgery, on postoperative days 1, 2, 7 and one day before discharge from the hospital. All patients were followed to postoperative day 30. Statistical design was presented by Pearson’s χ2 test and binomial logistic regression. The main result was significant difference between the four stratification subgroups of coronary patients in the incidence of cardiac death up to the 30th postoperative day: I - 0/17 (0.0%) vs. II - 0/40 (0.0%) vs. III - 1/37 (2.7%) vs. IV - 2/17 (11.8%), (p<0.05). We concluded that the incidence of perioperative cardiac complications significantly increased with the degree of Goldman’s CRI. There was significant difference in the incidence of perioperative cardiac complications between the four Goldman’s stratification subgroups.