Thakar et al developed a score for predicting the risk of acute renal failure after cardiac surgery. This can help identify patients who should be monitored more closely and who may benefit from early interventions. The authors are from the Cleveland Clinic and the University of Cincinnati in Ohio.
Parameters:
(1) gender
(2) congestive heart failure
(3) left ventricular ejection fraction
(4) COPD
(5) diabetes mellitus
(6) history of previous cardiac surgery
(7) status of surgical need
(8) preoperative use of intra-aortic balloon pump (IABP)
(9) type of cardiac surgery
(10) preoperative serum creatinine
Parameter |
Finding |
Points |
---|---|---|
gender |
male |
0 |
|
female |
1 |
congestive heart failure |
absent |
0 |
|
present |
1 |
left ventricular ejection fraction |
>= 35% |
0 |
|
< 35% |
1 |
COPD |
absent |
0 |
|
present |
1 |
insulin dependent diabetes mellitus |
absent |
0 |
|
present |
1 |
history of previous cardiac surgery |
absent |
0 |
|
present |
1 |
status of surgical need |
nonemergency |
0 |
|
emergency |
2 |
preoperative use of IABP |
no |
0 |
|
yes |
2 |
type of cardiac surgery |
CABG only |
0 |
|
valve surgery only |
1 |
|
CABG plus valve |
2 |
|
other cardiac surgery |
2 |
preoperative serum creatinine |
< 1.2 mg/dL |
0 |
|
1.2 - 2.09 mg/dL |
2 |
|
>= 2.1 mg/dL |
5 |
total score =
= SUM(points for all 10 parameters)
Interpretation:
• minimum score: 0
• maximum score: 17
Total Score |
Probability Acute Renal Failure and Dialysis |
---|---|
0 - 2 |
0.4% |
3 - 5 |
2% |
6 - 8 |
8-10% |
9 - 13 |
21% |
14 - 17 |
NA |
from Table 5
Purpose: To evaluate a patient who is undergoing cardiac surgery for the risk of developing acute renal failure after surgery using the score of Thakar et al.
Specialty: Nephrology, Clinical Laboratory
Objective: risk factors, severity, prognosis, stage
ICD-10: N17,