Evaluation of preoperative cardiac risk index values in patients undergoing vaginal surgery

OBJECTIVE: Our purpose was to evaluate the Goldman and the New York Heart Association cardiac risk index values in a female surgical population and evaluate age, hypertension, ischemic heart disease, glucose intolerance, cardiac arrhythmia, and estrogen replacement therapy as risk factors for perioperative cardiac morbidity in older women undergoing major vaginal surgery. STUDY DESIGN: A retrospective analysis was performed of perioperative cardiac morbidity in consecutive patients undergoing elective vaginal surgery between August 1987 and October 1993. RESULTS: Four hundred six patients were entered in the study. Eight patients had perioperative cardiac morbidity. The Goldman cardiac risk index and the New York Heart Association functional classification of heart disease were not significant indicators of perioperative cardiac morbidity in this group of patients. In the postmenopausal subgroup of 168 patients hypertension (p = 0.033) and ischemic heart disease (p = 0.004) were statistically significant risk factors for perioperative cardiac morbidity. Glucose intolerance, cardiac arrhythmia, and estrogen replacement therapy were not significant predictors. CONCLUSION: The Goldman cardiac risk index and the New York Heart Association functional classification of heart disease are of questionable utility in a female surgical population undergoing elective vaginal surgical procedures. Hypertension and ischemic heart disease are risk factors for perioperative cardiac morbidity in a postmenopausal subgroup of these patients.