Evolution of ideas on the assessment of cardiovascular risks in the perioperative period


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Abstract

Substantial advance has been made in operative surgery and anesthesiology; on the one hand, population ageing and, on the other, increasing surgical care needs make the prediction of perioperative complications an important component of the entire current model of surgical care. In the last decades, the concept of risk in perioperative medicine has been formulated; the theoretical base for a statistical description of the risk concept has been created, and different integral risk prediction models based on the risk index obtained by regression analysis have been elaborated and promoted. At the same time, none of the created models can reliably assess the risk of cardiovascular events associated with surgical intervention and predict the probability of poor clinical outcomes with a high degree of accuracy.

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Эволюция представлений об оценке риска развития сердечно-сосудистых осложнений в периоперационном периоде. - Аннотация. Значительные достижения в области оперативной хирургии и анестезиологии, с одной стороны, постарение населения и рост потребности в хирургической помощи, с другой, делают прогнозирование развития периоперационных осложнений важным компонентом всей современной модели оказания хирургической помощи. За последние десятилетия сформирована концепция риска в медицине периоперационного периода, создана теоретическая база для статистического описания понятия риска, разработаны и внедрены различные интегральные модели прогнозирования риска, основанные на получении индекса риска методом регрессионного анализа. В то же время пока ни одна из созданных моделей не позволяет надежно оценить риск развития сердечно-сосудистых осложнений, связанных с проведением хирургического вмешательства, и с высокой точностью прогнозировать вероятность развития неблагоприятных клинических исходов.
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