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Aging Clinical and Experimental Research

, Volume 30, Issue 5, pp 419–431 | Cite as

Addition of biomarker panel improves prediction performance of American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) calculator for cardiac risk assessment of elderly patients preparing for major non-cardiac surgery: a pilot study

  • Danica Z. Marković
  • Tatjana Jevtović-Stoimenov
  • Vladan Ćosić
  • Biljana Stošić
  • Bojana Marković Živković
  • Radmilo J. Janković
Original Article
  • 95 Downloads

Abstract

Background

Number of elderly patients subjected to extensive surgical procedures in the presence of cardiovascular morbidities is increasing every year. Therefore, there is a need to make preoperative diagnostics more accurate.

Aims

To evaluate the usefulness of American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) calculator as a predictive tool in preoperative assessment of cardiovascular risk in elderly patients.

Methods

This prospective pilot study included 78 patients who were being prepared for extensive non-cardiac surgeries under general anaesthesia. Their data have been processed on the interactive ACS NSQIP calculator. Blood sampling has been performed 7 days prior to surgery, and serum has been separated. Clinical, novel, and experimental biomarkers [hsCRP, H-FABP, and Survivin (BIRC5)] have been measured in specialized laboratories.

Results

Mean age of included patients was 71.35 ± 6.89 years. In the case of heart complications and mortality prediction, hsCRP and ACS NSQIP showed the highest specificity and sensitivity with AUC, respectively, 0.869 and 0.813 for heart complications and 0.883 and 0.813 for mortality. When combined with individual biomarkers AUC of ACS NSQIP raised, but if we combined all three biomarkers with ACS NSQIP, AUC reached as much as 0.920 for heart complications and 0.939 for mortality.

Discussion

ACS NSQIP proved to reduce inaccuracy in preoperative assessment, but it cannot be used independently, which has already been proved by other authors.

Conclusions

Our results indicate that ACS NSQIP represents an accurate tool for preoperative assessment of elderly patients, especially if combined with cardiac biomarkers.

Keywords

Period Preoperative; survivin protein Human; H-FABP Human; hsCRP Human 

Notes

Acknowledgements

We would like to thank Miodrag Krstić, Master Engineer of Electrical Engineering and Computer Science, for his assistance in statistical analyses of data.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

All included patients signed the informed consent.

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.General Surgery Clinic, Center for Anestesiology and ReanimatologyClinical Center in NišNisSerbia
  2. 2.Department for Biochemistry, Medical SchoolUniversity in NišNisSerbia
  3. 3.Center for Medical BiochemistryClinical Center in NišNisSerbia
  4. 4.Department for Emergency Medicine, Medical SchoolUniversity in NišNisSerbia
  5. 5.Medical High School ‘Dr. Milenko Hadžić’NisSerbia

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