Reduction in mortality from cardiac causes in Goldman class IV patients

Abstract

In 1977, Goldman et al evaluated cardiac patients for non-cardiac operations and showed a high incidence of cardiac death in high-risk cardiac patients (Goldman class IV). The present study was designed to prospectively evaluate the incidence of cardiac death as well as overall mortality in 49 patients belonging to Goldman class IV at the present time. Four patients of 49 (8.2%) died of cardiac causes, and seven other patients died of non-cardiac causes. Thus, the overall mortality rate was 22.4% ( 11 49 ). There has been a marked reduction in cardiac mortality from 56% in Goldman et al's 1977 data to 8.2% in the present data. All of the developments and advances in patient care over the past 10 years probably contributed to this reduction in mortality from cardiac causes.