A New Risk Prediction Model for the Assessment of Myocardial Injury in Elderly Patients Undergoing Non-Elective Surgery
<b>Background:</b> Currently, recommended pre-operative risk assessment models including the revised cardiac risk index (RCRI) are not very effective in predicting postoperative myocardial damage after non-elective surgery, especially for elderly patients. <b>Aims:</b> This s...
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| Format: | Article |
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MDPI AG
2024-12-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/12/1/6 |
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| author | Vedat Cicek Mert Babaoglu Faysal Saylik Samet Yavuz Ahmet Furkan Mazlum Mahmut Salih Genc Hatice Altinisik Mustafa Oguz Berke Cenktug Korucu Mert Ilker Hayiroglu Tufan Cinar Ulas Bagci |
| author_facet | Vedat Cicek Mert Babaoglu Faysal Saylik Samet Yavuz Ahmet Furkan Mazlum Mahmut Salih Genc Hatice Altinisik Mustafa Oguz Berke Cenktug Korucu Mert Ilker Hayiroglu Tufan Cinar Ulas Bagci |
| author_sort | Vedat Cicek |
| collection | DOAJ |
| description | <b>Background:</b> Currently, recommended pre-operative risk assessment models including the revised cardiac risk index (RCRI) are not very effective in predicting postoperative myocardial damage after non-elective surgery, especially for elderly patients. <b>Aims:</b> This study aimed to create a new risk prediction model to assess myocardial injury after non-cardiac surgery (MINS) in elderly patients and compare it with the RCRI, a well-known pre-operative risk prediction model. <b>Materials and Methods:</b> This retrospective study included 370 elderly patients who were over 65 years of age and had non-elective surgery in a tertiary hospital. Each patient underwent detailed physical evaluations before the surgery. The study cohort was divided into two groups: patients who had MINS and those who did not. <b>Results:</b> In total, 13% (48 out of 370 patients) of the patients developed MINS. Multivariable analysis revealed that creatinine, lymphocyte, aortic regurgitation (moderate-severe), stroke, hemoglobin, ejection fraction, and D-dimer were independent determinants of MINS. By using these parameters, a model called “CLASHED” was developed to predict postoperative MINS. The ROC analysis comparison demonstrated that the new risk prediction model was significantly superior to the RCRI in predicting MINS in elderly patients undergoing non-elective surgery (AUC: 0.788 vs. AUC: 0.611, <i>p</i> < 0.05). <b>Conclusions:</b> Our study shows that the new risk preoperative model successfully predicts MINS in elderly patients undergoing non-elective surgery. In addition, this new model is found to be superior to the RCRI in predicting MINS. |
| format | Article |
| id | doaj-art-e56c044d44c74e1dbe30197790eeacb8 |
| institution | Kabale University |
| issn | 2308-3425 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj-art-e56c044d44c74e1dbe30197790eeacb82025-01-24T13:35:56ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252024-12-01121610.3390/jcdd12010006A New Risk Prediction Model for the Assessment of Myocardial Injury in Elderly Patients Undergoing Non-Elective SurgeryVedat Cicek0Mert Babaoglu1Faysal Saylik2Samet Yavuz3Ahmet Furkan Mazlum4Mahmut Salih Genc5Hatice Altinisik6Mustafa Oguz7Berke Cenktug Korucu8Mert Ilker Hayiroglu9Tufan Cinar10Ulas Bagci11Machine & Hybrid Intelligence Lab, Department of Radiology, Northwestern University, Chicago, IL 60611, USASultan II. Abdulhamid Han Training and Research Hospital, Department of Cardiology, Health Sciences University, 34668 Istanbul, TurkeyVan Training and Research Hospital, Department of Cardiology, Health Sciences University, 65300 Van, TurkeySultan II. Abdulhamid Han Training and Research Hospital, Department of Cardiology, Health Sciences University, 34668 Istanbul, TurkeySultan II. Abdülhamid Han Training and Research Hospital, Department of General Surgery, Health Sciences University, 34668 Istanbul, TurkeySultan II. Abdülhamid Han Training and Research Hospital, Department of General Surgery, Health Sciences University, 34668 Istanbul, TurkeySultan II. Abdulhamid Han Training and Research Hospital, Department of Cardiology, Health Sciences University, 34668 Istanbul, TurkeySultan II. Abdulhamid Han Training and Research Hospital, Department of Cardiology, Health Sciences University, 34668 Istanbul, TurkeyDepartment of Internal Medicine, Rutgers\Robert Wood Johnson Barnabas Health, Jersey City Medical Center, Jersey City, NJ 07302, USADepartment of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital, 34668 Istanbul, TurkeySchool of Medicine, University of Maryland, Baltimore, MD 21201, USAMachine & Hybrid Intelligence Lab, Department of Radiology, Northwestern University, Chicago, IL 60611, USA<b>Background:</b> Currently, recommended pre-operative risk assessment models including the revised cardiac risk index (RCRI) are not very effective in predicting postoperative myocardial damage after non-elective surgery, especially for elderly patients. <b>Aims:</b> This study aimed to create a new risk prediction model to assess myocardial injury after non-cardiac surgery (MINS) in elderly patients and compare it with the RCRI, a well-known pre-operative risk prediction model. <b>Materials and Methods:</b> This retrospective study included 370 elderly patients who were over 65 years of age and had non-elective surgery in a tertiary hospital. Each patient underwent detailed physical evaluations before the surgery. The study cohort was divided into two groups: patients who had MINS and those who did not. <b>Results:</b> In total, 13% (48 out of 370 patients) of the patients developed MINS. Multivariable analysis revealed that creatinine, lymphocyte, aortic regurgitation (moderate-severe), stroke, hemoglobin, ejection fraction, and D-dimer were independent determinants of MINS. By using these parameters, a model called “CLASHED” was developed to predict postoperative MINS. The ROC analysis comparison demonstrated that the new risk prediction model was significantly superior to the RCRI in predicting MINS in elderly patients undergoing non-elective surgery (AUC: 0.788 vs. AUC: 0.611, <i>p</i> < 0.05). <b>Conclusions:</b> Our study shows that the new risk preoperative model successfully predicts MINS in elderly patients undergoing non-elective surgery. In addition, this new model is found to be superior to the RCRI in predicting MINS.https://www.mdpi.com/2308-3425/12/1/6cardiac revised indexelderlymyocardial injurynon elective surgerypre-op risk |
| spellingShingle | Vedat Cicek Mert Babaoglu Faysal Saylik Samet Yavuz Ahmet Furkan Mazlum Mahmut Salih Genc Hatice Altinisik Mustafa Oguz Berke Cenktug Korucu Mert Ilker Hayiroglu Tufan Cinar Ulas Bagci A New Risk Prediction Model for the Assessment of Myocardial Injury in Elderly Patients Undergoing Non-Elective Surgery Journal of Cardiovascular Development and Disease cardiac revised index elderly myocardial injury non elective surgery pre-op risk |
| title | A New Risk Prediction Model for the Assessment of Myocardial Injury in Elderly Patients Undergoing Non-Elective Surgery |
| title_full | A New Risk Prediction Model for the Assessment of Myocardial Injury in Elderly Patients Undergoing Non-Elective Surgery |
| title_fullStr | A New Risk Prediction Model for the Assessment of Myocardial Injury in Elderly Patients Undergoing Non-Elective Surgery |
| title_full_unstemmed | A New Risk Prediction Model for the Assessment of Myocardial Injury in Elderly Patients Undergoing Non-Elective Surgery |
| title_short | A New Risk Prediction Model for the Assessment of Myocardial Injury in Elderly Patients Undergoing Non-Elective Surgery |
| title_sort | new risk prediction model for the assessment of myocardial injury in elderly patients undergoing non elective surgery |
| topic | cardiac revised index elderly myocardial injury non elective surgery pre-op risk |
| url | https://www.mdpi.com/2308-3425/12/1/6 |
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