The Revised Cardiac Risk Index Delivers What It Promised

Annals of internal medicine (Impact Factor: 17.81). 01/2010; 152(1):57-8. DOI: 10.1059/0003-4819-152-1-201001050-00013
Source: PubMed
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    • "While contemporary surgical researchers had already employed multivariate statistical methods to examine mortality among patients with a particular operative illness (Irvin and Zeppa 1976), Goldman's index predicted the occurrence of any one of several potential negative outcomes, all linked to the dysfunction of a single organ system, across a range of surgical procedures. And while cardiac events had been recognized in Goldman's time to be a principal contributor to surgical morbidity and mortality (Arkins, Smessaert, and Hicks 1964; Tarhan et al. 1972), the " precise determination " promised by Goldman's approach was limited to the extent that it did not predict a range of other key end points, such as noncardiac complications or all-cause mortality, relevant to operative risk assessment (Goldman 2010). In contrast to the apparent " guesswork " implicit in earlier approaches to risk assessment, Goldman's index promised a precise, numerical estimate of risk but did so for only a selected set of complications, described in the 1981 edition of the Textbook of Surgery as " fatal and nonfatal, but life-threatening, complications of cardiac origin " (Polk 1981, 123). "
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