Risk Score Vascular Complications PCI - Medical Diagnostic Tool

Description

Piper et al developed a risk score for identifying patients likely to have a vascular complication associated with percutaneous coronary interventions (PCI). Most of the risk factors are known prior to the procedure, which allows identification of patients who may require closer monitoring and additional care. The authors are from Dartmouth-Hitchcock Medical Center, Maine Medical Center, Beth Israel Deaconess Medical Center and 4 other hospitals in New England.

Vascular complications include:

(1) vascular access site injury requiring surgical or procedural intervention

(2) bleeding requiring transfusion

Parameters:

(1) age in years

(2) gender

(3) body surface area

(4) comorbidities

(5) interventional priority

(6) indication

(7) number of lesions treated

(8) ACC lesion type

(9) drug therapy before or during the procedure

Parameter	Findings	Points
age in years	< 60 years	0
	60 - 69 years	1.5
	70 - 79 years	2.5
	>= 80 years	3.0
sex	male	0
	female	2
body surface area	> 1.8 square meters	0
	1.6 - 1.8	1.5
	< 1.6	2.0
comorbidities	none	0
	congestive heart failure	+1.5
	bleeding disorder	+1.5
	lower extremity vascular disease	+1.5
	COPD	+1.5
	renal failure or creatinine > 2 mg/dL	+2.0
priority	elective	0
	urgent	1.5
	emergent	2.0
indication	treatment for MI	1.5
	cardiogenic shock	2.0
	other	0
number of lesions treated	1 lesion	0
	2 lesions	1.5
	>= 3 lesions	1.5
ACC lesion type	A	0
	B1	0
	B2	1.5
	C	1.5
therapy	Ticlid or Pravix preprocedure	1.5
	GPIIb/IIIa before or during procedure	2

total score =

= SUM(points for all 9 parameters)

Interpretation:

• minimum score: 0

• maximum score: 24

• The higher the score the greater the risk of vascular complications.

Total Score	Mean Percent with Vascular Complication
0	0.3%
1	0.4%
2	0.5%
3	0.6%
4	0.8%
5	1.0%
6	1.2%
7	1.8%
8	2.5%
9	3.0%
10	4.5%
11	5.8%
12	7.5%
13	10%
14	12%

estimated from Figure 3

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Description

Specialty

Objective

ICD-10

Risk Score of Piper et al for Predicting Vascular Complications Associated with Percutaneous Coronary Intervention (PCI)

Purpose: To identify a patient undergoing a percutaneous coronary intervention (PCI) who is at risk for a vascular complication using the risk score of Piper et al.

Description

Specialty

Objective

ICD-10