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Cardiac risk strati...
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Bass, Gary Alan,1979-Örebro universitet,Institutionen för medicinska vetenskaper,Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Penn Presbyterian Medical Center, Philadelphia, Pennsylvania, USA
(author)
Cardiac risk stratification in emergency resection for colonic tumours
- Article/chapterEnglish2021
Publisher, publication year, extent ...
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2021-07-06
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John Wiley & Sons,2021
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electronicrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:oru-93335
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https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-93335URI
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https://doi.org/10.1093/bjsopen/zrab057DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:148805244URI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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BACKGROUND: Despite advances in perioperative care, the postoperative mortality rate after emergency oncological colonic resection remains high. Risk stratification may allow targeted perioperative optimization and cardiac risk stratification. This study aimed to test the hypothesis that the Revised Cardiac Risk Index (RCRI), a user-friendly tool, could identify patients who would benefit most from perioperative cardiac risk mitigation.METHODS: Patients who underwent emergency resection for colonic cancer from 2007 to 2017 and registered in the Swedish Colorectal Cancer Registry (SCRCR) were analysed retrospectively. These patients were cross-referenced by social security number to the Swedish National Board of Health and Welfare data set, a government registry of mortality, and co-morbidity data. RCRI scores were calculated for each patient and correlated with 90-day postoperative mortality risk, using Poisson regression with robust error of variance.RESULTS: Some 5703 patients met the study inclusion criteria. A linear increase in crude 90-day postoperative mortality was detected with increasing RCRI score (37.3 versus 11.3 per cent for RCRI 4 or more versus RCRI 1; P < 0.001). The adjusted 90-day all-cause mortality risk was also significantly increased (RCRI 4 or more versus RCRI 1: adjusted incidence rate ratio 2.07, 95 per cent c.i. 1.49 to 2.89; P < 0.001).CONCLUSION: This study documented an association between increasing cardiac risk and 90-day postoperative mortality. Those undergoing emergency colorectal surgery for cancer with a raised RCRI score should be considered high-risk patients who would most likely benefit from enhanced postoperative monitoring and critical care expertise.
Subject headings and genre
Added entries (persons, corporate bodies, meetings, titles ...)
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Forssten, Maximilian Peter,1996-Örebro universitet,Institutionen för medicinska vetenskaper,Division of Trauma and Emergency Surgery, Department of Surgery, Örebro University Hospital, Örebro, Sweden(Swepub:oru)mmfn
(author)
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Pourlotfi, Arvid,1995-Örebro universitet,Institutionen för medicinska vetenskaper,Division of Trauma and Emergency Surgery, Department of Surgery, Örebro University Hospital, Örebro, Sweden(Swepub:oru)adpi
(author)
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Ahl, Rebecka,1987-Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Division of Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; 5 Division of Trauma and Emergency Surgery, Department of Surgery, Karolinska University Hospital, Stockholm, Sweden(Swepub:oru)raal
(author)
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Cao, Yang,Associate Professor,1972-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Clinical Epidemiology and Biostatistics(Swepub:oru)yco
(author)
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Matthiessen, Peter,1957-Örebro universitet,Institutionen för medicinska vetenskaper,Division of Trauma and Emergency Surgery, Department of Surgery, Orebro University Hospital, Örebro, Sweden(Swepub:oru)pemn
(author)
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Mohseni, Shahin,1978-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Division of Trauma and Emergency Surgery, Department of Surgery, Örebro University Hospital, Örebro, Sweden(Swepub:oru)snmi
(author)
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Örebro universitetInstitutionen för medicinska vetenskaper
(creator_code:org_t)
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