Vascular Surgery Perioperative Mortality Model - Medical Algorithm

Description

Kertai et al developed a model for predicting the probability of perioperative mortality for a patient undergoing vascular surgery. This can help identify a patient who may require more aggressive management or a nonsurgical solution. The authors are from Erasmus Medical Center in Rotterdam, the Netherlands.

Parameters:

(1) type of vascular procedure (5 types)

(2) medical history (6 items)

(3) long-term medications (2 drugs)

Parameter	Finding	Points
repair of a ruptured abdominal aortic aneurysm (or other high risk procedure)	no	0
	yes	43
thoracoabdominal vascular surgery	no	0
	yes	26
surgery on abdominal aorta (or other intermediate to high risk procedure)	no	0
	yes	26
infrainguinal bypass (or other low to intermediate risk procedure)	no	0
	yes	15
carotid endarterectomy (or other low risk procedure)	no	0
	yes	0
ischemic heart disease	absent	0
	present	13
congestive heart failure	absent	0
	present	14
history of cerebrovascular event	absent	0
	present	10
hypertension	absent	0
	present	7
renal dysfunction	absent	0
	present	16
chronic pulmonary disease	absent	0
	present	7
beta blocker use	no	0
	yes	-15
statin use	no	0
	yes	-10

total risk score =

= SUM(points for all 13 items)

Interpretation:

• minimum score: -25

• maximum score: 100+

• The higher the total risk score the greater the risk of mortality.

If the curve in the figure on page 902 is analyzed the following equation is generated:

X =

= (0.1054 * (total score)) - 6.514

X =

= (0.000224 * ((total score)^2)) + (0.07853 * (total score)) - 5.843

probability of mortality =

= 1 / (1 + EXP((-1) * X))

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Description

Specialty

Objective

ICD-10

Model for Predicting Vascular Surgery Perioperative Mortality

Purpose: To predict the probability of perioperative death for a patient undergoing vascular surgery using the model of Kertai et al.

Description

Specialty

Objective

ICD-10