A Simple Risk Classification in Cardiac Surgery

Development: The score was developed at the Montreal Heart Hospital and was described in 1983. It has been evaluated in over 500 patients.

Risk factors:

(1) poor left ventricular function (ejection fraction < 0.3)

(2) unstable angina or recent myocardial infarction (transmural infarct less than 6 weeks before)

(3) evidence of heart failure

(4) age > 65 years

(5) severe obesity (body mass index > 30)

(6) emergency surgery

(7) re-operation

(8) other significant and uncontrolled systemic disturbances

risk score =

= number of risk factors present

Interpretation:

• minimum score: 0

• maximum score: 8

Limitations:

• The mortality rates were determined in 1983, and probably are lower today.

• The complexity of the operative procedure is not incorporated.