Description

Mehta et al developed a bedside tool for identifying patients who are likely to develop renal failure requiring dialysis following cardiac surgery. The authors are from the Society of Thoracic Surgeons National Cardiac Surgery Database Investigators.


Parameters:

(1) last serum creatinine in mg/dL

(2) age in years

(3) type of surgery

(4) diabetes mellitus

(5) history of a recent myocardial infarction (AMI)

(6) race

(7) chronic lung disease

(8) history of previous cardiovascular surgery

(9) NYHA class

(10) presence of cardiogenic shock

 

Parameter

Finding

Points

last serum creatinine in mg/dL

 

MIN(40, 10 * (serum creatinine))

age in years

< 55 years of age

0

 

55 to 59 years

1

 

60 to 64 years

2

 

65 to 69 years

3

 

70 to 74 years

4

 

75 to 79 years

5

 

80 to 84 years

6

 

85 to 89 years

7

 

90 to 94 years

8

 

95 to 99 years

9

 

>= 100 years

10

type of surgery

CABG only

0

 

aortic valve only

2

 

mitral valve only

4

 

CABG and aortic valve

5

 

CABG and mitral valve

7

diabetes

none

0

 

oral control

2

 

insulin required

5

recent MI

none

0

 

within past 3 weeks

3

race

White

0

 

non-White

2

chronic lung disease

absent

0

 

present

3

previous cardiac surgery

no

0

 

yes

3

NYHA class

I, II or III

0

 

IV

3

cardiogenic shock

absent

0

 

present

7

 

total score =

= SUM(points for all 10 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 83

• The higher the score the greater the risk for renal failure.

 

Total Score

Risk of Dialysis in Percent

< 12

0.2%

12 to 22

(0.01205 * ((score)^2)) - (0.2912 * (score)) + 2.077

22 to 42

(0.03109 * ((score)^2)) - (1.108 * (score)) + 10.78

43

19%

44 to 68

(0.05091 * ((score)^2)) - (3.157 * (score)) + 58.85

 


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