Patient selection: history of Fontan procedure for congenital heart disease many years previous (> 15 years)
Outcome: death or cardiac transplant
Parameters:
(1) VAS score (abbreviated VAST score for portal hypertension, with 1 point assigned for each of varices, ascites and splenomegaly)
(2) resting oxygen saturation (as a measure of hypoxemia)
(3) pacemaker placement
|
Parameter
|
Finding
|
Points
|
|
VAS score
|
0 or 1
|
0
|
|
|
2 or 3
|
1
|
|
resting oxygen saturation
|
normal
|
0
|
|
|
reduced
|
1
|
|
pacemaker
|
absent
|
0
|
|
|
present
|
1
|
where:
• Splenomegaly is present if the spleen has any dimension > 13 cm.
• Varices and ascites are present if seen on imaging or clinically.
• The mean oxygen saturation for all patients was 91%. Patients without adverse events had an oxygen saturation from 87 to 96%. Patients with adverse events had adverse events had oxygen saturation from 83 to 94%. No cutoff was specified in the paper. Less than 90% will be used in the implementation.
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 3
• The higher the score the greater the likelihood of major adverse events.
