Systematic review and consensus definitions for the Standardized Endpoints in Perioperative Medicine (StEP) intiative: cardiovascular outcomes
Year: 2021
Type: review
Abstract: Background: Adverse cardiovascular events are a leading cause of perioperative morbidity and mortality. The definitions of perioperative cardiovascular adverse events are heterogeneous. As part of the international Standardized Endpoints in Perioperative Medicine initiative, this study aimed to find consensus amongst clinical trialists on a set of standardised and valid cardiovascular outcomes for use in future perioperative clinical trials. Methods: We identified currently used perioperative cardiovascular outcomes by a systematic review of the anaesthesia and perioperative medicine literature (PubMed/Ovid, Embase, and Cochrane Library). We performed a three-stage Delphi consensus-gaining process that involved 55 clinician researchers worldwide. Cardiovascular outcomes were first shortlisted and the most suitable definitions determined. These cardiovascular outcomes were then assessed for validity, reliability, feasibility, and clarity. Results: We identified 18 cardiovascular outcomes. Participation in the three Delphi rounds was 100% (n=19), 71% (n=55), and 89% (n=17), respectively. A final list of nine cardiovascular outcomes was elicited from the consensus: myocardial infarction, myocardial injury, cardiovascular death, non-fatal cardiac arrest, coronary revascularisation, major adverse cardiac events, pulmonary embolism, deep vein thrombosis, and atrial fibrillation. These nine cardiovascular outcomes were rated by the majority of experts as valid, reliable, feasible, and clearly defined. Conclusions: These nine consensus cardiovascular outcomes can be confidently used as endpoints in clinical trials designed to evaluate perioperative interventions with the goal of improving perioperative outcomes.
Authors: Beattie, W. Scott, Lalu, Manoj, Bocock, Matthew, Feng, Simon, Wijeysundera, Duminda, Nagele, Peter, Fleisher, Lee A., Kurz, Andrea, Biccard, Bruce, Leslie, Kate, Howell, Simon, Landoni, Giovani, Grocott, Hilary, Lamy, Andre, Richards, Toby, Myles, Paul, Cooper, D. Jamie, Gan, T. J., Peyton, Phil, Sessler, Dan, Tramèr, Martin, Cyna, Alan, De Oliveira, Gildasio S., Wu, Christopher, Jensen, Mark, Kehlet, Henrik, Botti, Mari, Boney, Oliver, Haller, Guy, Grocott, Mike, Cook, Tim, Fleisher, Lee, Neuman, Mark, Story, David, Gruen, Russell, Bampoe, Sam, Evered, Lis, Scott, David, Silbert, Brendan, van Dijk, Diederik, Kalkman, Cor, Chan, Matthew, Eckenhoff, Rod, Rasmussen, Lars, Eriksson, Lars, Beattie, Scott, Landoni, Giovanni, Dieleman, Stefan, van Klei, Wilton, Organ Failure and Survival, Cancer Surgery, Patient Comfort, Clinical Indicators, Delirium Postoperative Cognitive Dysfunction Stroke, Cardiovascular, Data Extractors, Respiratory, Acute Kidney Injury, Inflammation Sepsis, Healthcare Resource Utilisation, Patient-Centred Outcomes, Medische Staf Intensive Care, Brain, Circulatory Health, Medische staf Anesthesiologie, Management Vitale Functies
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7150388682