Edelson et al reported the Emergency Department Ventricular Assist Device Risk Score for evaluating a patient with a ventricular assist device (VAD) in the Emergency Department. This can help to identify a patient who may require more aggressive management. The authors are from Children's Hospital of Philadelphia, University of Pennsylvania, and Bar Ilian University in Israel.
Patient selection: ventricular assist device (VAD) in the Emergency Department, >= 19 years old
Parameters:
(1) age in years
(2) primary diagnosis
(3) blood transfusion
(4) history of hypertension
Parameter
Finding
Points
age in years
19 to 64 years
0
>= 65 years
1
primary diagnosis
cardiac
2
device complication
4
infection
3
stroke
5
other
0
blood transfusion
no
0
yes
2
history of hypertension
no
0
yes
-1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: -1
• maximum score: 8
Total Score
Risk Category
Mortality
<= 1
low
1%
2 to 4
medium
3.7%
5 to 8
high
16%
Performance:
• The area under the ROC curve is 0.78 in the derivation and 0.71 in the validation cohorts.
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