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Model of Chertow et al for Predicting Acute Renal Failure Following Cardiac Surgery Based on Preoperative Risk Factors

Purpose: To predict the risk of a patient developing acute renal failure following cardiac surgery using the model of Chertow et al.

Description

Chertow et al used classification tree (CART) to identify patients at risk for acute renal failure (ARF) following cardiac surgery, based on preoperative factors. This can help identify patients who may require more aggressive management. The authors are from


Parameters:

(1) creatinine clearance in mL per minute

(2) history of prior heart surgery

(3) NYHA functional status

(4) valvular surgery being done

(5) intra-aortic balloon pump (IABP) in use

(6) cardiomegaly

(7) peripheral vascular disease (PVD)

 

For patients with a creatinine clearance >= 60 mL/min

 

History of Heart Surgery

Valvular Surgery

NYHA

Node in Tree

Y

NA

not IV

C

Y

NA

IV

D

N

N

NA

B

N

Y

not IV

E

N

Y

IV

F

 

For patients with a creatinine clearance < 60 mL/min

 

IABP

Cardiomegaly

NYHA

PVD

Valvular Surgery

Node in Tree

Y

NA

NA

NA

NA

A

N

Y

not IV

NA

NA

H

N

Y

IV

NA

NA

I

N

N

NA

N

NA

G

N

N

NA

Y

N

J

N

N

NA

Y

Y

K

 

 

Node in Tree

Percent ARF in Derivation Set

A

9.5%

B

0.4%

C

1.3%

D

2.8%

E

0.9%

F

2.1%

G

1.1%

H

2.3%

I

5%

J

2.1%

K

6.1%

 

where:

• In the validation set node A had 3.2% ARF; F 4.4%; H 4.9%.


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Specialty

Objective

ICD-10