SHM Converge Scientific Abstract ePoster Gallery-Esrd Patients Undergoing Surgery: Which Risk Score Calculator Performs Better?

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This retrospective study evaluated perioperative risk prediction in patients with end-stage renal disease (ESRD) using the NSQIP database from 2008–2012. The authors analyzed 31,948 surgical patients with ESRD and compared two risk tools: the Revised Cardiac Risk Index (RCRI), with creatinine excluded because all patients had ESRD, and the American University of Beirut HAS2 (AUB-HAS2) score.<br /><br />The study population had a mean age of 61.1 years, with high rates of comorbidities including hypertension (85%), diabetes (47%), and smoking (18.5%). Most surgeries were general (47.5%) or vascular (43.4%), and 17.7% were emergency cases. Overall, 10% of patients died during hospitalization, and 21.5% experienced the composite outcome of death, myocardial infarction (MI), or stroke.<br /><br />Risk increased with higher scores on both models. However, the scores performed differently depending on the outcome measured. AUB-HAS2 predicted mortality better than RCRI, with an area under the curve (AUC) of 0.68 versus 0.62. In contrast, RCRI performed better for the composite endpoint, with an AUC of 0.77 versus 0.679 for AUB-HAS2.<br /><br />The authors conclude that ESRD patients undergoing surgery are at very high risk for adverse events. For mortality prediction, AUB-HAS2 appears superior, but for predicting the broader composite outcome of death, MI, or stroke, RCRI performs better.

Asset Subtitle

Ritesh Patel

Meta Tag

Author List David Spurrier, Francis Spitz, Jean-Sebastien Rachoin, Katherine Dipastina, Krystal Hunter, Matthew Stern, Ritesh Patel, Vipul Bhat

Category Research

Concept AUB-HAS2

Concept Revised Cardiac Risk Index

Concept End-stage Kidney Disease

Concept Mortality

Concept Predictive Performance

Distinguished Non-Finalist

Presenter Organization Cooper University Healthcare

Presenting Author Ritesh Patel

Track Perioperative

Keywords

end-stage renal disease

perioperative risk prediction

NSQIP database

Revised Cardiac Risk Index

AUB-HAS2 score

surgical mortality

myocardial infarction

stroke

composite outcome

retrospective study

AUB-HAS2

Revised Cardiac Risk Index

End-stage Kidney Disease

Mortality

Predictive Performance