Hannan et al reported mortality risk scores for patients undergoing isolated valve or valve plus CABG procedures. These can help to identify a patient who may require more aggressive management. The authors are from State University of New York at Albany, New York University Medical Center, University of Connecticut, Drexel University, Columbia-Presbyterian Medical Center New York, Medical University of Ohio Toledo and Albana College of Pharmacy and Health Sciences.
Patient selection: valve surgery
Parameters:
(1) type of valve surgery
(2) age in years
(3) sex
(4) hemodynamic status
(5) left ventricular ejection fraction in percent
(6) history of previous AMI
(7) endocarditis
(8) cerebrovascular disease
(9) serum creatinine or dialysis
(10) left main coronary artery disease
(11) previous open heart surgery
Parameter
Finding
Points
type of valve surgery
aortic valve replacement
0
mitral valve repair
0
mitral valve replacement
2
multiple valve repair or replacement
4
age in years
<= 50 years
0
51 to 59 years
1
60 to 69 years
3
70 to 79 years
5
>= 80 years
7
sex
male
0
female
3
hemodynamic status
stable
0
unstable
5
LVEF
>= 30%
0
< 30%
2
history of previous AMI
none
0
within past 7 days
3
8 days or more ago
2
endocarditis
no
0
yes
4
cerebrovascular disease
no
0
yes
2
serum creatinine
< 1.3 mg/dL
0
1.3 to 1.5 mg/dL
2
1.6 to 2.5 mg/dL
4
> 2.5 mg/dL
5
on dialysis
8
left main coronary artery disease
no
0
yes
4
previous open-heart surgery
no
0
yes
2
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 44
• The higher the score the greater the in-hospital and 30-day mortality rate.
Total Score
Predicted Risk
0 to 3
< 1%
4 to 6
1%
7 or 8
2%
9
3%
10 or 11
4%
12
5%
13
7%
14
8%
15
10%
16
12%
17
15%
18
18%
19
21%
20
25%
21
30%
>= 22
78%
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