Fortescue et al developed classification tree for predicting acute renal failure (ARF) following coronary artery bypass graft (CABG) surgery. The tree is based on a study from the VA Continuous Improvement in Cardiac Surgery Program (CICSP). The authors are from Brigham and Women's Hospital and the University of California San Francisco.
Methodology: recursive partitioning analysis
Parameters:
(1) creatinine clearance in mL per minute
(2) intra-aortic balloon pump (IABP) inserted prior to surgery
(3) valvular surgery
(4) history of prior heart surgery
(5) NYHA functional status class IV
(6) peripheral vascular disease (PVD)
(7) left ventricular ejection fraction (LVEF)
|
CrCl |
IABP |
Valve |
Prior |
NYHA |
PVD |
LVEF |
Group |
|
< 60 |
Y |
|
|
|
|
|
A |
|
>= 60 |
|
N |
N |
|
|
|
B |
|
>= 60 |
|
|
Y |
N |
|
|
C |
|
>= 60 |
|
|
Y |
Y |
|
|
D |
|
>= 60 |
|
Y |
N |
N |
|
|
E |
|
>= 60 |
|
Y |
N |
Y |
|
|
F |
|
< 60 |
|
|
|
|
N |
>= 35% |
G |
|
< 60 |
N |
|
|
N |
|
< 35% |
H |
|
< 60 |
N |
|
|
Y |
|
< 35% |
I |
|
< 60 |
N |
N |
|
|
Y |
>= 35% |
J |
|
< 60 |
N |
Y |
|
|
Y |
>= 35% |
K |
where:
• The parameters are the same as for the risk score shown in the previous section, except that the following are not included: pulmonary rales (CHF), chronic obstructive pulmonary disease (COPD) and systolic blood pressure.
|
Group |
Rate ARF QMMI Cohort |
Rate ARF CICSP Study |
|
A |
4.2% |
3.2% |
|
B |
0.7% |
3.2% |
|
C |
0.8% |
1.4% |
|
D |
1.5% |
2.5% |
|
E |
|
1.1% |
|
F |
|
4.4% |
|
G |
1.4% |
1.4% |
|
H |
1.9% |
4.9% |
|
I |
4.1% |
5.9% |
|
J |
2.4% |
1.6% |
|
K |
|
7.1% |
Specialty: Nephrology, Clinical Laboratory
