Preoperative Assessment and Management of Cardiovascular Risk in Patients Undergoing Non-Cardiac Surgery: Implementing a Systematic Stepwise Approach during the COVID-19 Pandemic Era
Major adverse cardiac events, defined as death or myocardial infarction, are common causes of perioperative mortality and major morbidity in patients undergoing non-cardiac surgery. Reduction of perioperative cardiovascular risk in relation to non-cardiac surgery requires a stepwise patient evaluation that integrates clinical risk factors, functional status and the estimated stress of the planned surgical procedure. Major guidelines on preoperative cardiovascular risk assessment recommend to establish, firstly, the risk of surgery per se (low, moderate, high) and the related timing (elective vs. urgent/emergent), evaluate the presence of unstable cardiac conditions or a recent coronary revascularization (percutaneous coronary intervention or coronary artery bypass grafting), assess the functional capacity of the patient (usually expressed in metabolic equivalents), determine the value of non-invasive and/or invasive cardiovascular testing and then combine these data in estimating perioperative risk for major cardiac adverse events using validated scores (Revised Cardiac Risk Index (RCRI) or National Surgical Quality Improvement Program (NSQIP)). This stepwise approach has the potential to guide clinicians in determining which patients could benefit from cardiovascular therapy and/or coronary artery revascularization before non-cardiac surgery towards decreasing the incidence of perioperative morbidity and mortality. Finally, it should be highlighted that there is a need to implement specific strategies in the 2019 Coronavirus disease (COVID-19) pandemic to minimize the risk of transmission of COVID-19 infection during the preoperative risk assessment process..
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:8 |
|---|---|
| Enthalten in: |
Journal of Cardiovascular Development and Disease - 8(2021), 10, p 126 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Eduardo Bossone [VerfasserIn] |
|---|
| Links: |
doi.org [kostenfrei] |
|---|
| Themen: |
COVID-19 |
|---|
| doi: |
10.3390/jcdd8100126 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
DOAJ009002987 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | DOAJ009002987 | ||
| 003 | DE-627 | ||
| 005 | 20240412135302.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 230225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.3390/jcdd8100126 |2 doi | |
| 035 | |a (DE-627)DOAJ009002987 | ||
| 035 | |a (DE-599)DOAJ286da8786a8a4ec0b90f0352713e7054 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 050 | 0 | |a RC666-701 | |
| 100 | 0 | |a Eduardo Bossone |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Preoperative Assessment and Management of Cardiovascular Risk in Patients Undergoing Non-Cardiac Surgery: Implementing a Systematic Stepwise Approach during the COVID-19 Pandemic Era |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 520 | |a Major adverse cardiac events, defined as death or myocardial infarction, are common causes of perioperative mortality and major morbidity in patients undergoing non-cardiac surgery. Reduction of perioperative cardiovascular risk in relation to non-cardiac surgery requires a stepwise patient evaluation that integrates clinical risk factors, functional status and the estimated stress of the planned surgical procedure. Major guidelines on preoperative cardiovascular risk assessment recommend to establish, firstly, the risk of surgery per se (low, moderate, high) and the related timing (elective vs. urgent/emergent), evaluate the presence of unstable cardiac conditions or a recent coronary revascularization (percutaneous coronary intervention or coronary artery bypass grafting), assess the functional capacity of the patient (usually expressed in metabolic equivalents), determine the value of non-invasive and/or invasive cardiovascular testing and then combine these data in estimating perioperative risk for major cardiac adverse events using validated scores (Revised Cardiac Risk Index (RCRI) or National Surgical Quality Improvement Program (NSQIP)). This stepwise approach has the potential to guide clinicians in determining which patients could benefit from cardiovascular therapy and/or coronary artery revascularization before non-cardiac surgery towards decreasing the incidence of perioperative morbidity and mortality. Finally, it should be highlighted that there is a need to implement specific strategies in the 2019 Coronavirus disease (COVID-19) pandemic to minimize the risk of transmission of COVID-19 infection during the preoperative risk assessment process. | ||
| 650 | 4 | |a non-cardiac surgery | |
| 650 | 4 | |a perioperative cardiovascular management | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a teleconsulting | |
| 653 | 0 | |a Diseases of the circulatory (Cardiovascular) system | |
| 700 | 0 | |a Filippo Cademartiri |e verfasserin |4 aut | |
| 700 | 0 | |a Hani AlSergani |e verfasserin |4 aut | |
| 700 | 0 | |a Salvatore Chianese |e verfasserin |4 aut | |
| 700 | 0 | |a Rahul Mehta |e verfasserin |4 aut | |
| 700 | 0 | |a Valentina Capone |e verfasserin |4 aut | |
| 700 | 0 | |a Carlo Ruotolo |e verfasserin |4 aut | |
| 700 | 0 | |a Imran Hayat Tarrar |e verfasserin |4 aut | |
| 700 | 0 | |a Antonio Frangiosa |e verfasserin |4 aut | |
| 700 | 0 | |a Olga Vriz |e verfasserin |4 aut | |
| 700 | 0 | |a Vincenzo Maffei |e verfasserin |4 aut | |
| 700 | 0 | |a Roberto Annunziata |e verfasserin |4 aut | |
| 700 | 0 | |a Domenico Galzerano |e verfasserin |4 aut | |
| 700 | 0 | |a Brigida Ranieri |e verfasserin |4 aut | |
| 700 | 0 | |a Chiara Sepe |e verfasserin |4 aut | |
| 700 | 0 | |a Andrea Salzano |e verfasserin |4 aut | |
| 700 | 0 | |a Rosangela Cocchia |e verfasserin |4 aut | |
| 700 | 0 | |a Massimo Majolo |e verfasserin |4 aut | |
| 700 | 0 | |a Giuseppe Russo |e verfasserin |4 aut | |
| 700 | 0 | |a Giuseppe Longo |e verfasserin |4 aut | |
| 700 | 0 | |a Mario Muto |e verfasserin |4 aut | |
| 700 | 0 | |a Paolo Fedelini |e verfasserin |4 aut | |
| 700 | 0 | |a Ciro Esposito |e verfasserin |4 aut | |
| 700 | 0 | |a Alessandro Perrella |e verfasserin |4 aut | |
| 700 | 0 | |a Gianluca Guggino |e verfasserin |4 aut | |
| 700 | 0 | |a Eliana Raiola |e verfasserin |4 aut | |
| 700 | 0 | |a Mara Catalano |e verfasserin |4 aut | |
| 700 | 0 | |a Maurizio De Palma |e verfasserin |4 aut | |
| 700 | 0 | |a Luigia Romano |e verfasserin |4 aut | |
| 700 | 0 | |a Gaetano Romano |e verfasserin |4 aut | |
| 700 | 0 | |a Ciro Coppola |e verfasserin |4 aut | |
| 700 | 0 | |a Ciro Mauro |e verfasserin |4 aut | |
| 700 | 0 | |a Rajendra H. Mehta |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i In |t Journal of Cardiovascular Development and Disease |d MDPI AG, 2014 |g 8(2021), 10, p 126 |w (DE-627)DOAJ000052191 |x 23083425 |7 nnns |
| 773 | 1 | 8 | |g volume:8 |g year:2021 |g number:10, p 126 |
| 856 | 4 | 0 | |u https://doi.org/10.3390/jcdd8100126 |z kostenfrei |
| 856 | 4 | 0 | |u https://doaj.org/article/286da8786a8a4ec0b90f0352713e7054 |z kostenfrei |
| 856 | 4 | 0 | |u https://www.mdpi.com/2308-3425/8/10/126 |z kostenfrei |
| 856 | 4 | 2 | |u https://doaj.org/toc/2308-3425 |y Journal toc |z kostenfrei |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_DOAJ | ||
| 951 | |a AR | ||
| 952 | |d 8 |j 2021 |e 10, p 126 | ||