A COMPARISON OF CLINICAL INDEX AND EJECTION FRACTIONS IN PREDICTING CARDIAC COMPLICATIONS FOLLOWING INFRARENAL AORTIC RECONSTRUCTION

Objective: To compare the Detsky clinical cardiac risk index with ejec tion fraction measurements in predicting postoperative cardiac events. Design: Prospective study. Setting: District General Hospital. Materi als: 48 patients undergoing infrarenal aortic reconstruction. Chief ou tcome measures: Ejection fractions were measured both by echocardiogra phy and a technetium 99 MUGA scan. Main results: Three patients develo ped four major cardiac events (LVF three, fatal myocardial infarction one). Fourteen patients experienced 15 minor cardiac events (arrhythmi a 11, ST segment depression Jour). The clinical index predicted postop erative cardiac problems (p=0.0001). There was no correlation between ejection fraction measurement and postoperative cardiac events nor bet ween ejection fraction measurements and the clinical index. Combining the index with ejection fraction measurement provided no additional in formation over the index alone. Conclusions: Calculation of a clinical index before aortic reconstruction is a simple and reliable way of se lecting patients who are at risk of developing postoperative cardiac e vents.