Comparison of the performance of the AUB-HAS2 Cardiovascular Risk Index in emergency vs elective surgeries

• Published in: Journal of cardiology Vol. 84; no. 1; pp. 55 - 58
• Main Authors: Sbaity, Eman, Tamim, Hani, Zalaquett, Nader G., Zein, Omar, Dakik, Habib A.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.07.2024
• Subjects: AUB-HAS2 Cardiovascular Risk Index; Elective surgery; Emergency surgery; AUB-HAS2 Cardiovascular Risk Index; Emergency surgery; Elective surgery
• ISSN: 0914-5087; 1876-4738; 1876-4738
• DOI: 10.1016/j.jjcc.2024.02.007

The AUB-HAS2 Cardiovascular Risk Index is a newly derived tool for preoperative cardiovascular evaluation. It is based on six data elements: history of heart disease, symptoms of angina or dyspnea, age ≥ 75 years, hemoglobin < 12 g/dl, vascular surgery, and emergency surgery. This study compares the performance of this new index among emergency and elective surgeries. The study population consisted of 1,167,414 non-cardiac surgeries registered in the American College of Surgeons National Surgical Quality Improvement Program database (153,715 were emergency and 1,013,699 were elective). Each patient was given an AUB-HAS2 score of 0, 1, 2, 3, or >3 depending on the number of data elements s/he has. The outcome measure (death, myocardial infarction, or stroke at 30 days after surgery) was higher in emergency than elective surgeries (7.0 % vs 1.4 %, p < 0.0001). The AUB-HAS2 index was able to stratify risk in both types of surgeries with a gradual increase in risk as the score increased (p < 0.0001). The discriminatory power of the AUB-HAS2 index, measured by the area under the receiver operator characteristic curves, was good and similar in the two types of surgeries (0.804 for emergency vs 0.791 for elective surgeries). The AUB-HAS2 index is a versatile tool that can effectively and equally stratify risk in both emergency and elective surgeries with a good discriminatory power. We compared the performance of the AUB-HAS2 Cardiovascular Risk Index between elective and emergency noncardiac surgeries in 1,167,414 patients registered in the American College of Surgeons National Surgical Quality Improvement Program database. The AUB-HAS2 index is a newly derived tool for preoperative cardiovascular evaluation that is based on six data elements: history of heart disease, symptoms of angina or dyspnea, age ≥ 75 years, hemoglobin <12 g/dl, vascular surgery, and emergency surgery. Each patient was given an AUB-HAS2 score of 0, 1, 2, 3, or >3 depending on the number of data elements s/he has. The outcome measure was death, myocardial infarction, or stroke at 30 days after surgery. The AUB-HAS2 index was able to stratify risk in both types of surgeries with a gradual increase in risk as the score increased as depicted in the Figure. The AUB-HAS2 index is a versatile tool that can effectively and equally stratify risk in both emergency and elective surgeries with a very good discriminatory power. [Display omitted] •We compared the performance of the AUB-HAS2 risk index among emergency and elective surgeries.•The population consisted of 1,167,414 patients registered in the ACS-NSQIP database.•The discriminatory power of the AUB-HAS2 index was very good in both types of surgeries.•The AUB-HAS2 index effectively stratifies risk in both emergency and elective surgeries.