American University of Beirut (AUB)-HAS2 Cardiovascular Risk Index

Why did you develop the AUB-HAS2 cardiovascular index? 

Pre-operative cardiovascular risk assessment is an essential step in the evaluation of patients undergoing non-cardiac surgery. It is now endorsed by several guidelines. Many risk indices have been previously published: some are powerful, but complex, while others are simple but have a weak discriminatory power. The American University of Beirut (AUB)-HAS2 risk index was derived to provide a simple and powerful tool for cardiovascular risk assessment in patients undergoing non-cardiac surgery with contemporary surgical and anesthesiologic techniques. The index is based on six easily acquired data elements: history of Heart disease, symptoms of Heart disease (angina or dyspnea), Age ≥ 75 years, Anemia (hemoglobin < 12 mg/dl), vascular Surgery, and emergency Surgery. It can stratify patients undergoing non-cardiac surgery into three risk groups: Low (score 0-1), intermediate (score 2-3), and high (score >3), with a strong discriminative power to predict a composite outcome of all-cause mortality, myocardial infarction, or stoke at 30 days after surgery. The index has been validated prospectively in a cohort of patients from the American University of Beirut and retrospectively in a large sample of over a million patients from the American College of Surgeons National Surgical Quality Improvement Program database.

Habib Dakik, MD, FACC, is a tenured professor of medicine and chief of cardiology at the American University of Beirut Medical Center, Lebanon. He is board certified in cardiology and interventional cardiology, is a fellow of the American College of Cardiology, and has received numerous international awards in recognition of his excellence in clinical research. Dr. Dakik’s primary research is focused on the risk stratification of patients with acute coronary syndromes and the development of new risk indices for the preoperative evaluation of patients undergoing noncardiac surgery.