Calificación de riesgo operatorio en cirugía de tórax no cardíaca

Abstract

Assessment of surgical risk is essential when submitting patients to a procedure in order to avoid perioperative complications. Lengthy wait times in performing such assessment create important delays for surgical solution. An updating of the conventional assessment (Goldman) was performed by incorporating lung, kidney and cardiac risk rates to improve prediction of morbidity and mortality, merging them into a single, comprehensive assessment (CARIOPE- Spanish initials for Perioperative Risk Rating), obtaining a fi nal score by adding individual rates, which yielded three statistically signifi cant risk levels. A prospective, observational, and descriptive study was conducted, applying CARIOPE to each patient who underwent non- ambulatory, non-cardiac surgery from September 1, 2010 to May 18, 2012, with a patient follow up during the fi rst 30 postoperative days to document morbidity and mortality in each risk level. Statistical analysis was performed using PASW statistics v.18 yielding a total of 1,097 patients, a morbidity of 12.3%, and a mortality of 3.3%. Statistically signifi cant values were obtained for the prediction of cardiac, lung, and kidney complications, among others (p < 0.05). CARIOPE is an effective tool for the assessment of perioperative risk in various organ systems and is not confi ned to cardiac risk. Key word: Preoperative assessment, surgical risk index, surgical complications, morbidity and mortality rate.