Huijskes et al developed models for predicting outcomes following coronary artery bypass graft and/or cardiac valve surgery. One model describes the risk for in-hospital mortality. The authors are from Amphia Hospital in Breda, The Netherlands.
Parameters:
(1) age in years
(2) gender
(3) serum creatinine in µmol/L
(4) left ventricular ejection fraction
(5) history of previous cardiac surgery
(6) myocardial infarction (AMI) in the past 24 hours
(7) timing for the surgery
(8) type of surgery
|
Parameter |
Finding |
Points |
|---|---|---|
|
age |
<=60 |
0 |
|
|
> 60 |
see below |
|
gender |
male |
0 |
|
|
female |
1 |
|
serum creatinine |
< 150 µmol/L |
0 |
|
|
150 to 200 µmol/L |
3 |
|
|
> 200 µmol/L |
6 |
|
left ventricular ejection fraction |
fair to good |
0 |
|
|
poor |
2 |
|
history of previous cardiac surgery |
no |
0 |
|
|
yes |
4 |
|
AMI in past 24 hours |
no |
0 |
|
|
yes |
5 |
|
timing for the surgery |
routine or urgent |
0 |
|
|
emergency |
3 |
|
type of surgery |
combined CABG and mitral valve surgery |
4 |
|
|
other |
0 |
points for age over 60 =
= ROUNDUP((age) – 60)/5,0)
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score 33 or more
• The higher the score the greater the risk for in-hospital mortality.
|
Total Score |
Risk |
|---|---|
|
0 to 3 |
low |
|
4 or 5 |
low to moderate |
|
6 to 8 |
moderate |
|
9 or 10 |
moderate to high |
|
11 or more |
high |
The authors also gave the equation from multivariate analysis:
|
Parameter |
Beta |
|---|---|
|
age, per 5 years after 60 years of age |
0.41 |
|
female gender |
0.58 |
|
serum creatinine at 3 levels (< 150, 150 to 200, > 200) |
1.20 |
|
poor left ventricular ejection fraction |
0.92 |
|
history of prior cardiac surgery |
1.45 |
|
AMI in past 24 hours |
1.96 |
|
emergency procedure |
1.09 |
|
combined CABG and mitral valve procedure |
1.00 |
|
coefficient |
-6.84 |
Purpose: To predict in-hospital mortality following coronary artery bypass graft (CABG) and/or valve surgery using the Amphiascore model.
Specialty: Cardiology, Surgery, general
Objective: risk factors, severity, prognosis, stage, complications, selection
ICD-10: I97.1,
