UCSF - University of California, San Francisco
US Dept of Veteran Affairs, San Francisco
home | lessons | search  



The Beta Blocker and Clonidine Protocol

Lesson 3
Risk Stratification

10. Cardiac Risk Stratification:
Can it ever be good for you?

The risk of a cardiac event in a patient at high risk undergoing non-cardiac surgery is 3%. The risk of death from CABG is 3.2%. The risk of a stroke is 3% or more. The risk of being admitted to a nursing home after CABG is 10%. And the risk of neurocognitive defects after an on-pump CABG is 95%. The risk of death for non-cardiac surgery after CABG is 1.5%. So, it is really difficult for the total risk (3.2% (CABG) + 1.5% (non-cardiac after CABG) to be less than (3% risk of non-cardiac without CABG). The patient experiences the total risk of care. That risk includes the risk of the risk stratification, the risk of the treatment for the identified risk, and then the risk of the planned non-cardiac procedure. Total risk is what the patient cares about. What about a PTCA or PCI, may be they could help?

Risk It?

What is the risk of the proposed therapy?

Risk of CABG:

bullet Death 3.2%
bullet Stroke 3.0%
bullet Other neurologic events 3.0%
bullet Neurocognitive defects 95%
bullet Nursing Home Placement 10%
bullet At least one complication 100%

Risk of PTCA-PCI-Anti-Platelets-Coated Stent

bullet Complex

Click here if you want sound narration.
If audio does not begin after two minutes, please click the speaker icon above for narration.


Content by Art Wallace MD PhD
Web Design by Plumsites

home ] register ] lessons ] downloads ] resources ] forum ]