Andersson et al reported a score for predicting gastrointestinal complications in a patient undergoing cardiac surgery. The authors are from Lund University and Lund University Hospital in Sweden.
Patient selection: status post cardiac surgery
Outcome: GI complications (GI bleeding, perforation, intestinal ischemia, liver failure, pancreatitis, acute cholecystitis, paralytic ileus)
Parameters:
(1) age in years
(2) smoking status
(3) preoperative inotropic support
(4) NYHA class
(5) duration of cardiopulmonary bypass in minutes
(6) postoperative atrial fibrillation
(7) postoperative heart failure
(8) reoperation due to bleeding
(9) postoperative vascular complications
Parameter |
Finding |
Points |
age |
<= 80 years |
0 |
|
> 80 years |
2.5 |
smoking status |
never or former |
0 |
|
active |
2.5 |
preoperative inotropic support |
no |
0 |
|
yes |
4 |
NYHA class |
I or II |
0 |
|
III or IV |
2 |
duration cardiopulmonary bypass |
<= 150 minutes |
0 |
|
> 150 minutes |
2.5 |
postoperative atrial fibrillation |
no |
0 |
|
yes |
2.5 |
postoperative heart failure |
no |
0 |
|
yes |
3.5 |
reoperation for bleeding |
no |
0 |
|
yes |
3.5 |
postoperative vascular complication |
no |
0 |
|
yes |
9.5 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 32.5
• The higher the score the greater the risk of gastrointestinal complications.
Score |
GI Complication Rate |
<= 5 |
< 0.4% |
10 |
2.5% |
12 |
10% |
15 |
22% |
19 |
50% |
Performance:
• The area under the ROC curve is 0.81.
Specialty: Gastroenterology