Cardiology Consultation in Noncardiac Surgery

NCT05532917 | Completed

• 1 other identifier: 10.1.2022 128/21
• Study Type: observational
• Target: 898
• Locations: 1 country
• Sites: 1

Brief Summary

Recently, a predictive model has been developed to assess the risk of myocardial infarction or cardiac arrest (MICA) during and after surgery using the American Society of Surgeons' National Surgical Quality Improvement Program (NSQIP) database. In this MICA model, 180 hospital databases were used in 2007 and 2008 and included more than 200 000 patients. The Gupta score developed with this MICA model identified five predictors of perioperative myocardial infarction and cardiac arrest: type of surgery, functional status, creatinine increase (\>130 mmol/L or \>1.5 mg/dL), age, and American Association of Anesthesiologists (ASA) class. The Gupta score is presented as an interactive risk calculation program in the 2014 guideline of the ACC/AHA. The risk can be calculated simply and accurately at the bedside or clinic. The Gupta score is in spreadsheet format and can be downloaded online at http://www.surgicalriskcalculator.com/miorcardiacarrest. Unlike the previously used indexes, a scoring system has not been established. An estimate of the probability of myocardial infarction/cardiac arrest is provided for individual patients. In this study, the primary aim was to compare the frequency of cardiology consultation requests according to the use of the Gupta score. The secondary aim is to evaluate the perioperative clinical results (coronary angiography, ECHO, acute coronary syndrome, arrhythmia, 30-day mortality, etc.).SPSS 21.0 (Version 22.0, SPSS, Inc, Chicago, IL, USA) program will be used for statistical analysis. After applying the Shapiro-Wilk test for normality, the student's t-test will be used if the distribution is normal, and the Mann-Whitey U test will be used if the distribution is not normal. Fisher's exact test or chi-square test will be used for categorical variables. Results p\<0.05 will be considered significant.

Conditions

Myocardial Infarction; Surgery-Complications

Keywords

ACC/AHA guidelines; Perioperative cardiac risk; Cardiology consultation

Outcome Measures

Primary Outcomes (1)

• Gupta score

  The frequency of cardiology consultation requests will be compared according to the use of the Gupta score.

  perioperative period

Secondary Outcomes (1)

• Perioperative clinical results

  perioperative period

Study Arms (2)

Gupta group

Cardiology consultation requested using Gupta score

Other: Gupta score

Non-Gupta group

Number of cardiology consultations requested without using Gupta score

Interventions

Gupta score OTHER

The Gupta score is presented as an interactive risk calculation program in the 2014 guideline of the ACC/AHA. The Gupta score developed with this MICA model identified five predictors of perioperative myocardial infarction and cardiac arrest: type of surgery, functional status, creatinine increase (\>130 mmol/L or \>1.5 mg/dL), age, and American Association of Anesthesiologists (ASA) class. The frequency of cardiology consultation requests will be investigated according to the use of the Gupta score.

Gupta group

Eligibility Criteria

• Age: 18 Years - 99 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Patients over the age of 18 who will be referred to the anesthesia polyclinic and will undergo non-cardiac surgery will be included in the study. Cardiology consultation will be requested from these patients according to the Gupta score. Additional tests or examinations may be requested if the cardiologist deems it necessary.

You may qualify if:

• Patients undergoing non-cardiovascular surgery
• Patients evaluated routinely preoperatively in the anesthesiologist preoperative outpatient clinic

You may not qualify if:

• Emergency surgeries
• ASA Physical Status V
• Patients undergoing cardiovascular surgery
• Minor surgeries
• Patients who did not want to participate in the study

Sponsors & Collaborators

• Diskapi Yildirim Beyazit Education and Research Hospital: lead

Study Sites (1)

University of Medical Science, Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey

Altındağ, Ankara, 06000, Turkey (Türkiye)

Location

Related Publications (3)

• Cinello M, Nucifora G, Bertolissi M, Badano LP, Fresco C, Gonano N, Fioretti PM. American College of Cardiology/American Heart Association perioperative assessment guidelines for noncardiac surgery reduces cardiologic resource utilization preserving a favourable clinical outcome. J Cardiovasc Med (Hagerstown). 2007 Nov;8(11):882-8. doi: 10.2459/JCM.0b013e3280122d63.

  PMID: 17906472 BACKGROUND

• Glance LG, Faden E, Dutton RP, Lustik SJ, Li Y, Eaton MP, Dick AW. Impact of the Choice of Risk Model for Identifying Low-risk Patients Using the 2014 American College of Cardiology/American Heart Association Perioperative Guidelines. Anesthesiology. 2018 Nov;129(5):889-900. doi: 10.1097/ALN.0000000000002341.

  PMID: 30001221 BACKGROUND

• Madi-Jebara S, Chalhoub V, Jabbour K, Yazigi A, Haddad F, Richa F, El-Hage C, Yazbeck P. [Audit on preoperative cardiac evaluation before non-cardiac surgery: the importance of a pocket guide to improve the anaesthesist's adhesion to ACC/AHA guidelines]. Ann Fr Anesth Reanim. 2009 Oct;28(10):850-4. doi: 10.1016/j.annfar.2009.08.007. Epub 2009 Oct 29. French.

  PMID: 19879104 BACKGROUND

MeSH Terms

Conditions

Myocardial Infarction

Condition Hierarchy (Ancestors)

Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Vascular Diseases; Infarction; Ischemia; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Necrosis

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Target Duration: 1 Month
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: September 5, 2022
• First Posted: September 8, 2022
• Study Start: January 15, 2022
• Primary Completion: March 31, 2023
• Study Completion: April 12, 2023
• Last Updated: April 13, 2023

Record last verified: 2023-04

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)