Miceli et al developed a score for predicting the need for an intra-aortic balloon pump (IABP) in a patient undergoing a coronary artery bypass graft (CABG) procedure. The authors are from the Bristol Heart Institute, the University of Bristol and University of Tor Vegata (Rome).
Patient selection: CABG
Outcome: need for IABP
Parameters:
(1) age of the patient in years
(2) Canadian Cardiovascular Society (CCS) class
(3) history of previous cardiac surgery
(4) left ventricular ejection fraction
(5) interval between a myocardial infarction and surgery in days
(6) percent occlusion of the left main stem coronary artery
(7) acuity of surgery
Parameter
Finding
Points
age of the patient in years
<= 70 years
0
> 70 years
2
CCS class
1 or 2
0
3 or 4
2
history of previous cardiac surgery
no
0
yes
3
left ventricular ejection fraction
> 50%
0
30 to 50%
2
< 30%
7
interval between AMI and surgery
< 30 days
2
>= 30 days
0
percent occlusion left main stem artery
<= 50%
0
> 50%
2
acuity of surgery
emergency
3
not emergency
0
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 21
• The higher the score the greater the likelihood of an IABP.
Score
Risk
Percent
0 to 6
low
1 to 2%
7 to 13
medium
7 to 11%
14 to 21
high
36 to 39%
Performance:
• The area under the ROC curve is 0.77.
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