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Colombian Journal of Anesthesiology
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Colombian Journal of Anesthesiology
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Colombian Journal of Anesthesiology
Article . 2014
License: CC BY NC ND
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Sensibilidad, especificidad y valores predictivos de los índices cardíacos de Goldman, Detsky y Lee

Authors: Pantoja Muñoz, Hernán Javier; Fernández Ramos, Humberto; Guevara Tovar, William Leandro;

Sensibilidad, especificidad y valores predictivos de los índices cardíacos de Goldman, Detsky y Lee

Abstract

ResumenIntroducciónReconocer oportunamente las variables de riesgo perioperatorio permite predecir la frecuencia de morbimortalidad, así como tomar medidas a fin de reducir complicaciones. Para ello se han creado varias escalas de riesgo en pacientes portadores de enfermedad cardiovascular.ObjetivoDeterminar la sensibilidad, la especificidad y los valores predictivos de los índices de riesgo cardíaco de Goldman, Detsky y Lee para cirugía no cardíaca.MétodoSe realizó un estudio observacional, analítico, longitudinal y prospectivo del total de pacientes portadores de enfermedad cardiovascular con enfermedad quirúrgica no cardíaca en el período comprendido entre enero de 2011 y enero de 2013 en el Hospital Universitario Manuel Ascunce Domenech de la ciudad de Camagüey. La muestra estuvo constituida por 88 pacientes comprendidos en el universo que cumplieron con los criterios de inclusión. Las variables estudiadas fueron: edad, sexo, tipo de cirugía, tipo de complicación, y la presencia o no de estas en relación con el riesgo catalogado según los índices de Goldman, Detsky y Lee. Se aplicó prueba de sensibilidad, especificidad y valores predictivos.ResultadosPredominaron los pacientes mayores de 70años, el sexo masculino, la cirugía ortopédica; la arritmia cardíaca fue la principal complicación. Fue frecuente encontrar pacientes de alto riesgo, en los cuales la mayoría sufrieron complicaciones.ConclusionesLos índices de Goldman y Detsky mostraron alta sensibilidad y especificidad, y el índice de Lee, mayor valor predictivo positivo. No obstante, deben aplicarse los 3 índices predictivos para lograr una óptima estratificación del riesgo cardíaco en cirugía no cardíaca.AbstractIntroductionTimely recognition of perioperative risk variables helps predict morbidity and mortality frequency, as well as adopt measures to reduce complications. Several risk scores have been developed for this purpose in patients with cardiovascular disease.ObjectiveTo determine the sensitivity, specificity and predictive values of the Goldman, Detsky and Lee cardiac risk indices for non-cardiac surgery.MethodsObservational, analytical, longitudinal prospective study of the total number of patients with cardiovascular disease undergoing non-cardiac surgery between January 2011 and January 2013 at Hospital Universitario Manuel Ascunce Domenech in Camagüey. The sample consisted of 88 patients included in the universe of patients who met the inclusion criteria. The variables studied were: age, gender, type of surgery, type of complication, and the presence or absence of complications in relation to the risk assessed on the basis of the Goldman, Detsky and Lee indices. The sensitivity, specificity and predictive value test was applied.ResultsThere was a predominance of males in patients over 70 years of age coming for orthopaedic surgery; cardiac arrhythmiawas the main complication. High-risk patientswere a frequent finding and the majority suffered complications.ConclusionsThe Goldman and Detsky indices showed high sensitivity and specificity, while the Lee index showed higher positive predictive value. However, the three predictive indices must be applied in order to optimize cardiac risk stratification in non-cardiac surgery.

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Keywords

Detsky index, Preoperative cardiovascular risk, Goldman index, Riesgo cardiovascular preoperatorio, Índice de Goldman, Critical Care and Intensive Care Medicine, Índice de Detsky, Índice de Lee, Anesthesiology and Pain Medicine, Lee index

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
3
Average
Average
Average
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gold