ACS NSQIP study defines cardiac risk factors of common surgical procedures

Editor's Note

This analysis of 3 million elective surgical procedures in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) found a broad range of procedure-specific intrinsic cardiac adverse event risks associated with 200 commonly performed procedures.

A total of 66 low, 30 intermediate, and 106 high intrinsic risks were identified. Excisional breast biopsy had the lowest intrinsic cardiac risk at 0.03%, and aorto-bifemoral bypass grafting had the highest at 1.43%, a nearly 48-fold greater risk.

Other high-risk procedures were cystectomy with ileal conduit, pylorus-preserving pancreatoduodenectomy, and Ivor-Lewis esophagectomy. Examples of other low-risk procedures included laparoscopic appendectomy, sleeve gastrectomy, and cholecystectomy.

Broad groupings of surgical procedures, as is conventionally done, can be misleading because they do not consider the continuum of intrinsic cardiac risk that exists for each procedure, the authors note.