A comparison of clinical index and ejection fractions in predicting cardiac complications following infrarenal aortic reconstruction.

Abstract

To compare the Detsky clinical cardiac risk index with ejection fraction measurements in predicting postoperative cardiac events. Prospective study. District General Hospital. 48 patients undergoing infrarenal aortic reconstruction. Ejection fractions were measured both by echocardiography and a technetium 99 MUGA scan. Three patients developed four major cardiac events (LVF three, fatal myocardial infarction one). Fourteen patients experienced 15 minor cardiac events (arrhythmia 11, ST segment depression four). The clinical index predicted postoperative cardiac problems (p = 0.0001). There was no correlation between ejection fraction measurement and postoperative cardiac events nor between ejection fraction measurements and the clinical index. Combining the index with ejection fraction measurement provided no additional information over the index alone. Calculation of a clinical index before aortic reconstruction is a simple and reliable way of selecting patients who are at risk of developing postoperative cardiac events.