Department of Anaesthesiology and Intensive Care, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medyków 14, 40-772, Katowice, Poland.
Department of Anaesthesiology and Intensive Therapy, Silesian Centre for Heart Diseases, Zabrze, Poland.
Sci Rep. 2024 Apr 3;14(1):7826. doi: 10.1038/s41598-024-56887-5.
Cardiovascular complications represent a significant proportion of adverse events during the perioperative period, necessitating accurate preoperative risk assessment. This study aimed to investigate the association between well-established risk assessment tools and self-reported preoperative physical performance, quantified by metabolic equivalent (MET) equivalents, in high-risk patients scheduled for elective abdominal surgery. A prospective cross-sectional correlation study was conducted, involving 184 patients admitted to a Gastrointestinal Surgery Department. Various risk assessment tools, including the Revised Cardiac Risk Index (RCRI), Surgical Mortality Probability Model (S-MPM), American University of Beirut (AUB)-HAS2 Cardiovascular Risk Index, and Surgical Risk Calculator (NSQIP-MICA), were utilized to evaluate perioperative risk. Patients self-reported their physical performance using the MET-REPAIR questionnaire. The findings demonstrated weak or negligible correlations between the risk assessment tools and self-reported MET equivalents (Spearman's ρ = - 0.1 to - 0.3). However, a statistically significant relationship was observed between the ability to ascend two flights of stairs and the risk assessment scores. Good correlations were identified among ASA-PS, S-MPM, NSQIP-MICA, and AUB-HAS2 scores (Spearman's ρ = 0.3-0.8). Although risk assessment tools exhibited limited correlation with self-reported MET equivalents, simple questions regarding physical fitness, such as the ability to climb stairs, showed better associations. A comprehensive preoperative risk assessment should incorporate both objective and subjective measures to enhance accuracy. Further research with larger cohorts is needed to validate these findings and develop a comprehensive screening tool for high-risk patients undergoing elective abdominal surgery.
心血管并发症在围手术期的不良事件中占很大比例，因此需要进行准确的术前风险评估。本研究旨在探讨在择期腹部手术的高危患者中，经过验证的风险评估工具与自我报告的术前体力表现（通过代谢当量[MET]表示）之间的关系。进行了一项前瞻性的横断面相关性研究，共纳入 184 名收入胃肠外科病房的患者。使用修订后的心脏风险指数（RCRI）、手术死亡率概率模型（S-MPM）、贝鲁特美国大学（AUB）-HAS2 心血管风险指数和手术风险计算器（NSQIP-MICA）等各种风险评估工具来评估围手术期风险。患者使用 MET-REPAIR 问卷自我报告其体力表现。研究结果表明，风险评估工具与自我报告的 MET 当量之间的相关性较弱或可忽略不计（Spearman's ρ=-0.1 到-0.3）。然而，在能够爬上两段楼梯的能力与风险评估评分之间观察到统计学上的显著关系。ASA-PS、S-MPM、NSQIP-MICA 和 AUB-HAS2 评分之间存在良好的相关性（Spearman's ρ=0.3-0.8）。尽管风险评估工具与自我报告的 MET 当量之间相关性有限，但有关身体健康的简单问题，例如爬楼梯的能力，与风险评估评分的相关性更好。全面的术前风险评估应结合客观和主观措施以提高准确性。需要进行进一步的研究，以更大的队列验证这些发现，并为接受择期腹部手术的高危患者开发全面的筛查工具。
