Evidence map›Paper›PMID 34330222›Full record

ArticleBMC cardiovascular disorders2021

Effectiveness of a new cardiac risk scoring model reclassified by QRS fragmentation as a predictor of postoperative cardiac event in patients with severe renal dysfunction.

Hyun Jun Cho, Namkyun Kim, Hyeon Jeong Kim, Bo Eun Park, Hong Nyun Kim, Se Yong Jang, Myung Hwan Bae, Jang Hoon Lee, Dong Heon Yang, Hun Sik Park and 2 more

Open access · goldAbstract read
In one paragraph

Article in BMC cardiovascular disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 48% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. [Advances in the application of the HEART score in patients with acute coronary syndromes].Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2026
    Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 2 institutions in 1 country.

Hyun Jun ChoDepartment of Cardiology, Daegu Fatima Hospital, Daegu, Republic of Korea.
Namkyun KimDepartment of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Hyeon Jeong KimDepartment of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Bo Eun ParkDepartment of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Hong Nyun KimDepartment of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Se Yong JangDepartment of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Myung Hwan BaeDepartment of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea. bmh0325@knu.ac.kr.
Jang Hoon LeeDepartment of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Dong Heon YangDepartment of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Hun Sik ParkDepartment of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Yongkeun ChoDepartment of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Shung Chull ChaeDepartment of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Kyungpook National University · KRDaegu Fatima Hospital · KR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIt is difficult to evaluate the risk of patients with severe renal dysfunction before surgery due to various limitations despite high postoperative cardiac events. This study aimed to investigate the value of a newly reclassified Revised Cardiac Risk Index (RCRI) that incorporates QRS fragmentation (fQRS) as a predictor of postoperative cardiac events in patients with severe renal dysfunction.

methodsAmong the patients with severe renal dysfunction, 256 consecutive patients who underwent both a nuclear stress test and noncardiac surgery were evaluated. We reclassified RCRI as fragmented RCRI (FRCRI) by integrating fQRS on electrocardiography. We defined postoperative major adverse cardiac event (MACE) as a composite of cardiac death, nonfatal myocardial infarction, and pulmonary edema.

resultsTwenty-eight patients (10.9%) developed postoperative MACE, and this was significantly frequent in patients with myocardial perfusion defect (41.4% vs. 28.0%, p = 0.031). fQRS was observed 84 (32.8%) patients, and it was proven to be an independent predictor of postoperative MACE after adjusting for the RCRI (odds ratio 3.279, 95% confidence interval (CI) 1.419-7.580, p = 0.005). Moreover, fQRS had an incremental prognostic value for the RCRI (chi-square = 7.8, p = 0.005), and to the combination of RCRI and age (chi-square = 9.1, p = 0.003). The area under curve for predicting postoperative MACE significantly increased from 0.612 for RCRI to 0.667 for FRCRI (p = 0.027) and 23 patients (32.4%) originally classified as RCRI 2 were reclassified as FRCRI 3.

conclusionsA newly reclassified FRCRI that incorporates fQRS, is a valuable predictor of postoperative MACE in patients with severe renal dysfunction undergoing noncardiac surgery.

Indexed as

Decision Support TechniquesElectrocardiographyAgedAged, 80 and overFemaleHeart DiseasesHumansKidneyKidney DiseasesMaleMiddle AgedMyocardial IschemiaMyocardial Perfusion ImagingPredictive Value of TestsRetrospective StudiesRisk AssessmentFragmented QRSPostoperative cardiac complicationSevere renal dysfunction

Identifiers

PMID34330222
PMCPMC8323309
OpenAlexW3184392583

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.