The Comprehensive Risk Assessment for Bypass (CRAB) score of Meltzer et al can help aid the evaluation of a patient with critical limb ischemia. It can identify a patient who may benefit from an endovascular approach. The authors are from Weill Cornell Medical Center and New York Presbyterian Hospital.
Patient selection: critical limb ischemia in perioperative period
Parameters:
(1) age in years
(2) history of amputation and/or revascularization
(3) ulceration
(4) functional dependence
(5) hemodialysis
(6) recent angina or acute myocardial infarction (AMI)
(7) timing for surgery
|
Parameter |
Finding |
Points |
|
age in years |
<= 75 years of age |
0 |
|
|
> 75 years of age |
3 |
|
history of amputation and/or revascularization |
no |
0 |
|
|
yes |
3 |
|
ulceration |
no (pain) |
0 |
|
|
yes |
3 |
|
functional dependence |
none |
0 |
|
|
partial |
3 |
|
|
total (complete) |
6 |
|
hemodialysis |
no |
0 |
|
|
yes |
4 |
|
recent angina or AMI |
no |
0 |
|
|
yes |
4 |
|
timing of surgery |
emergency |
6 |
|
|
nonemergency |
0 |
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 29
• The higher the score the greater the morbidity and mortality.
|
Total Score |
Mortality |
Major Morbidity |
|
0 to 6 |
1% |
16% |
|
7 to 12 |
5% |
19% |
|
13 to 29 |
11% |
33% |
where:
• Table V shows morbidity and mortality with percentages less than major morbidity.
Specialty: Anesthesiology
ICD-10: ,
