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Preoperative Risk Score of Guaragna et al for a Patient Undergoing Cardiac Valve Surgery

Purpose: To predict mortality in a patient undergoing valve surgery using the logistic regression model of Guaragna et al.

Description

Guaragna et al developed a risk score for evaluating a patient prior to cardiac valve surgery. This can help to identify a patient at increased risk for postoperative mortality. The authors are from Hospital Sao Lucas da Pontificia Universidade Catolica do Rio Grande do Sul in Brazil.


NOTE: The logistic regression model developed from the same study is reported in the next section.

 

Patient selection: candidate for cardiac valve replacement >= 18 years of age

 

Outcome: death during hospitalization

 

Parameters:

(1) age

(2) timing of the surgery

(3) gender

(4) left ventricular ejection fraction in percent (LVEF)

(5) concurrent coronary artery bypass graft surgery (CABG)

(6) pulmonary arterial hypertension (PAH)

(7) NYHA functional class

(8) serum creatinine in mg/dL

 

Parameter

Finding

Points

age

< 60 years of age

0

 

>= 60 years of age

3

timing of the surgery

elective

0

 

urgent or emergency

17

gender

male

0

 

female

2

LVEF

> 45%

0

 

<= 45%

2

concurrent CABG

no

0

 

yes

3

pulmonary arterial hypertension

no

0

 

yes

2

NYHA functional class

I or II

0

 

III or IV

2

serum creatinine

< 1.5 mg/dL

0

 

1.5 to 2.49 mg/dL

2

 

>= 2.5 mg/dL or dialysis

6

 

total score =

= SUM(points for all 8 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 37

• The higher the score the higher the mortality.

 

Total Score

Risk Group

Mortality

0 to 3

low

2%

4 to 6

medium

8%

7 to 9

high

16%

10 to 13

very high

22%

14 to 37

extremely high

64%

 


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Specialty

Objective

ICD-10