November 17, 2017
    

The Geriatric‐Sensitive Cardiac Risk Index (GSCRI) better predicts the risk for cardiac-related complications in older patients undergoing non-cardiac surgery than current methods, according to the findings of a recent study.

The researchers developed a model using the National Surgical Quality Improvement Program (NSQIP) 2013 cohort of 210,914 adults aged 65 years and older, which was validated using the NSQIP 2012 cohort of 172,905 adults aged 65 years and older. To determine the model’s efficacy, the researchers compared the area under the curve (UC) of the GSCRI with the AUC of the Revised Cardiac Risk Index (RCRI) and Gupta Myocardial Infarction and Cardiac Arrest (MICA) calculator.

Overall, the GSCRI had an AUC of 0.76 in the validation cohort. Likewise, a subset of patients showed a similar AUC of 0.76 for the GSCRI, which was significantly greater than the RCRI and Gupta MICA. The GSCRI outperformed the RCRI by 13% and the Gupta MICA by 6%.

In addition, the researchers found that the AUC of Gupta deteriorated significantly when evaluated with the validation cohort, and significantly underestimated the risk for cardiac complications.

“Current risk‐prediction models have poor performance in geriatric patients; therefore, we developed a new index, the GSCRI, to help improve the accuracy of prediction in this unique population,” the researchers concluded. The GSCRI as a new tool is a work in progress, and we expect to continuously update and improve this new index as more data become available.”

—Melissa Weiss

Reference:

Alrezk R, Jackson N, Rezk MA, et al. Derivation and validation of a Geriatric‐Sensitive Perioperative Cardiac Risk Index [published online November 16, 2017]. J Am Heart Assoc. https://doi.org/10.1161/JAHA.117.006648.