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Comparative Study
. 2024 Sep 14;24(1):263.
doi: 10.1186/s12893-024-02536-7.

Assessing the accuracy of the revised Cardiac Risk Index compared to the American Society of Anaesthesiologists physical status classification in predicting Pulmonary and Cardiac complications among non-cardiothoracic surgery patients at Muhimbili National Hospital: a prospective cohort study

Elias Makoye Chrisant  1 , Ramadhan Hassani Khamisi  2 , Frank Muhamba  2   3 , Ally Hamis Mwanga  2 , Hervé Tshikomba Mbuyamba  2   4
Affiliations
Comparative Study

Assessing the accuracy of the revised Cardiac Risk Index compared to the American Society of Anaesthesiologists physical status classification in predicting Pulmonary and Cardiac complications among non-cardiothoracic surgery patients at Muhimbili National Hospital: a prospective cohort study

Elias Makoye Chrisant et al. BMC Surg. .

Abstract

Background: The Revised Cardiac Risk Index (RCRI) and the American Society of Anaesthesiologists (ASA-PS) classification system are two commonly used tools for preoperative risk assessment. This study aimed to assess the accuracy of RCRI compared to the ASA-PS classification system in preoperative risk assessment for pulmonary and cardiac problems among non-cardiothoracic surgery patients admitted at Muhimbili National Hospital (MNH).

Methods: This was a prospective cohort study design conducted from August 2022 to April 2023 among 184 patients of 18 years and above admitted at MNH for elective non-cardiothoracic surgery. Data Analysis was conducted using STATA software version 16. Means and standard deviations were used to summarize continuous data. Frequencies and percentages were used to summarize categorical data. The logistic regression and ROC curve analysis were used to determine the correlation between variables.

Results: The majority of patients (43.3%) had an RCRI score of 1 point, and 39.9% were classified as ASA class 1. Patients in ASA classes 3 and 4 had higher odds of developing cardiac and pulmonary complications (AUC = 0.75 and 0.77, respectively). Patients with an RCRI score of 2 or ≥ 3 points were also more likely to experience cardiac and pulmonary complications (AUC = 0.73 and 0.72, respectively). There was no significant difference in the predictive ability of the two tools. Both RCRI and ASA-PS classification systems were equally effective in predicting these complications.

Conclusion: Both the RCRI and the ASA-PS classification system demonstrated good predictive ability for cardiac and pulmonary complications among patients undergoing non-cardiothoracic surgery.

Keywords: ASA-PS; Cardiac complications; Preoperative risk assessment; Pulmonary complications; RCRI.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
A ROC curve analysis comparing the accuracies of ASA-PS classification and RCRI score in predicting cardiac complications among non-cardiothoracic surgery patients at MNH
Fig. 2
Fig. 2
A ROC curve analysis comparing the accuracies of ASA-PS classification and RCRI score in predicting pulmonary complications among non-cardiothoracic surgery patients at MNH
See this image and copyright information in PMC

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