ON THE COVER:
The 2014 American College of Cardiology Perioperative Guideline recommends risk stratifying patients scheduled to undergo noncardiac surgery using either the Revised Cardiac Index, the American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator, or the Myocardial Infarction or Cardiac Arrest calculator. In this issue of Anesthesiology, Glance et al. used a retrospective cohort of 10,000 patient records to determine how often these three risk-prediction tools agree on the classification of patients as low risk of major adverse cardiac event. They demonstrated wide variability in the predicted risk of cardiac complications using different risk-prediction tools. In an accompanying Editorial View, Fleisher, who served as chair of the Perioperative Guideline Committee, discusses the practical implications of using risk-prediction tools and the current lack of evidence that use of any one tool leads to superior patient outcomes.
Glance et al.: Impact of the Choice of Risk Model for Identifying Low-risk Patients Using the 2014 American College of Cardiology/American Heart Association Perioperative Guidelines, p. 889
Fleisher: Preoperative Cardiac Evaluation before Noncardiac Surgery Reverend Bayes’s Risk Indices and Optimal Variables, p. 867