Surgery Today

, Volume 44, Issue 2, pp 277–284

Clinical utility of the Revised Cardiac Risk Index in non-cardiac surgery for elderly patients: a prospective cohort study

Authors

  • Yuki Hirano
    • Department of SurgerySchool of Medicine, Keio University
    • Department of SurgerySchool of Medicine, Keio University
  • Koichi Suda
    • Department of SurgerySchool of Medicine, Keio University
  • Takashi Oyama
    • Department of SurgerySchool of Medicine, Keio University
  • Rieko Nakamura
    • Department of SurgerySchool of Medicine, Keio University
  • Tsunehiro Takahashi
    • Department of SurgerySchool of Medicine, Keio University
  • Hirofumi Kawakubo
    • Department of SurgerySchool of Medicine, Keio University
  • Norihito Wada
    • Department of SurgerySchool of Medicine, Keio University
  • Yoshiro Saikawa
    • Department of SurgerySchool of Medicine, Keio University
  • Hideaki Obara
    • Department of SurgerySchool of Medicine, Keio University
  • Hiromitsu Jinno
    • Department of SurgerySchool of Medicine, Keio University
  • Hirotoshi Hasegawa
    • Department of SurgerySchool of Medicine, Keio University
  • Minoru Tanabe
    • Department of SurgerySchool of Medicine, Keio University
  • Yuko Kitagawa
    • Department of SurgerySchool of Medicine, Keio University
Original Article

DOI: 10.1007/s00595-013-0543-3

Cite this article as:
Hirano, Y., Takeuchi, H., Suda, K. et al. Surg Today (2014) 44: 277. doi:10.1007/s00595-013-0543-3

Abstract

Purpose

We investigated the association between the Revised Cardiac Risk Index (RCRI) and postoperative outcomes in patients undergoing non-cardiac surgery.

Methods

The predictive value of the RCRI for the risk of perioperative complications, length of hospital stay and hospital cost were evaluated from a prospective cohort of 119 patients aged ≥65 years undergoing elective major digestive, breast or vascular surgery.

Results

Comparing three groups RCRI 0, 1 and ≥2, the morbidity rates were 0, 30 and 68 %; the median length of hospitalization was 5, 14 and 28 days; and the median cost was 665,000, 1,480,000 and 2,160,000 yen, respectively. The mortality rate was 0 % in all groups. The RCRI 0 group included only non-high-risk (breast and peripheral vascular) surgeries. In addition, comparing the two groups by excluding non-high-risk surgeries (RCRI 1 and ≥2), the median morbidity rates were 31 and 67 %, the median length of hospitalization was 15 and 28 days, and the median cost was 1,550,000 and 2,130,000 yen, respectively. The RCRI score was the only independent predictor of the perioperative complications.

Conclusions

In the case of non-cardiac surgery, the RCRI can identify patients at higher risk of perioperative complications, a prolonged hospital stay and higher hospital cost.

Keywords

Revised Cardiac Risk IndexNon-cardiac surgeryComplicationsHospital stayHospital cost

Copyright information

© Springer Japan 2013