Skip to main content
eScholarship
Open Access Publications from the University of California

Scholarly Works (2 results)

  • Thesis
  • Peer Reviewed
UCLA Electronic Theses and Dissertations (2016)

Surgical patients age 65 and over face a high risk of cardiac complications. The Revised Cardiac Risk Index (RCRI) and the Gupta Myocardial Infarction or Cardiac Arrest (MICA) are widely used to predict perioperative cardiac risk but they are not specifically designed to predict that risk in geriatric patients. The objective of this study is to develop and validate a geriatric-sensitive cardiac risk index (GSCRI). Three variables were selected using Lasso regression in the National Surgical Quality Improvement Program (NSQIP) 2013 with the addition of four clinically significant variables. The model was developed using the NSQIP 2013 geriatric cohort (N=485,426) (172,905 age ≥ 65) and validated on the NSQIP 2012 geriatric cohort (N=485,426) (210,914 age ≥ 65). The Area under the Curve (AUC) for the NSQIP 2012 geriatric cohort for three indices was compared. Gupta MICA had an AUC of 0.70 and the RCRI had an AUC of 0.63. Our GSCRI model showed better performance with an AUC of 0.76

    Cover page: The Derivation and Validation of a Geriatric-Sensitive Perioperative Cardiac Risk Index (GSCRI)
    • Article
    • Peer Reviewed
    UCLA Previously Published Works (2015)
    Cancer and cardiovascular disease (CVD) are two major causes of mortality in older adults. With improved survival and outcomes from cancer and CVD, the role of the geriatrician is evolving. Geriatricians provide key skills to facilitate patient-centered and value-based care in the growing older population of cancer patients (and survivors). Cancer treatment in older adults is particularly injurious with respect to complications stemming from cancer therapy and as well as to CVD related to cancer therapy in the context of physiologic aging. To best meet their natural potential as caregiving leaders, geriatricians must hone skills and insights pertaining to oncologic and cardiovascular care, insights that can inform and enhance key management expertise. In this paper, we will review common chemotherapy and radiation-induced cardiovascular complications, screening recommendations, and advance the concept of a geriatric, cardiology, and oncology collaboration. We assert that geriatricians are well suited to a leadership role in the care of older cardio-oncology patients and in the education of primary care physicians and subspecialists on geriatric principles.
      Cover page: The Crossroads of Geriatric Cardiology and Cardio-Oncology
      Top