EVALUATION OF PREOPERATIVE CARDIAC RISK INDEX VALUES IN PATIENTS UNDERGOING VAGINAL SURGERY

OBJECTIVE: Our purpose was to evaluate the Goldman and the New York He art Association cardiac risk index values in a female surgical populat ion and to evaluate age, hypertension, ischemic heart disease, glucose intolerance, cardiac arrhythmia, and estrogen replacement therapy as risk factors for perioperative cardiac morbidity in older women underg oing major vaginal surgery. STUDY DESIGN: A retrospective analysis was performed of perioperative cardiac morbidity in consecutive patients undergoing elective vaginal surgery between August 1987 and October 19 93. RESULTS: Four hundred six patients were entered in the study. Eigh t patients had perioperative cardiac morbidity. The Goldman cardiac ri sk index and the New York Heart Association functional classification of heart disease were not significant indicators of perioperative card iac morbidity in this group of patients. In the postmenopausal subgrou p of 168 patients hypertension (p = 0.033) and ischemic heart disease (p = 0.004) were statistically significant risk factors for perioperat ive cardiac morbidity. Glucose intolerance, cardiac arrhythmia, and es trogen replacement therapy were not significant predictors. CONCLUSION : The Goldman cardiac risk index and the New York Heart Association fu nctional classification of heart disease are of questionable utility i n a female surgical population undergoing elective vaginal surgical pr ocedures. Hypertension and ischemic hear? disease are risk factors for perioperative cardiac morbidity in a postmenopausal subgroup of these patients.