Usage of Cardiac Risk Scores During Anesthetic Assessment Before Cardiovascular Surgery: A Survey Study

Objectives: There are different risk scoring systems (RSSs) for preoperatively determining the risk of cardiovascular surgery. Herein, we aimed to determine which of the current RSSs are used at the national level to assess patients who are planned for cardiovascular surgery.
Methods: A survey was conducted electronically or via face-to-face interviews. The number and rate of physicians using RSSs in combination with the American Society of Anesthesiologists (ASA) Physical Status Classification (ASA PSC) were determined. Additionally, the extent to which patients and their relatives were informed about the preoperatively predicted cardiac risk was determined.
Results: Of the 139 participating physicians, only 125 were analyzed. The ASA PSC (n=123, 98.4%), EuroSCORE II (n=48, 38.4%), and CARE score (n=23, 18.4%) were the most commonly used scoring systems for determining the risk level. Among the physicians who used the ASA PSC, 67 (53.6%) only used the ASA PSC. The other 56 (44.8%) physicians used one or more RSSs in combination with the ASA PSC. EuroSCORE II (n=48, 38.4%) was commonly used to determine the risk. Only 16 physicians (12.8%) reported using the ASA PSC, EuroSCORE II, and CARE score in combination, (the most frequent triplet combination). Furthermore, 74 physicians (59.2%) informed the patients and their relatives about the preoperative risk.
Conclusion: In our study, the ASA PSC was used by almost all the participants. However, current cardiac RSSs were not frequently used in clinical practice at the national level. Thus, we believe that current RSSs should be more widely used to determine the risk level in patients awaiting cardiovascular surgery.