Bernstein and Parsonnet developed a model for predicting the risk of cardiac surgery. This consists of a subscore for core risk factors and a subscore for special risk factors. The authors are from Newark Beth Israel Medical Center in New Jersey.
Number of special risk factors: 22
|
Parameter |
Finding |
Points |
|
cardiogenic shock |
no |
0 |
|
|
yes |
12 |
|
endocarditis |
no |
0 |
|
|
treated |
0 |
|
|
active |
6.5 |
|
left ventricular aneurysm resected |
no |
0 |
|
|
yes |
1.5 |
|
tricuspid valve procedure |
no |
0 |
|
|
yes |
5 |
|
pacemaker dependency |
no |
0 |
|
|
yes |
0 |
|
transmural AMI in past 48 hours |
no |
0 |
|
|
yes |
4 |
|
ventricular septal defect, acute |
no |
0 |
|
|
yes |
12 |
|
ventricular arrhythmia |
no |
0 |
|
|
ventricular tachycardia. ventricular fibrillation, aborted sudden death |
1 |
|
asthma |
no |
0 |
|
|
yes |
1 |
|
preoperative endotracheal tube |
no |
0 |
|
|
yes |
4 |
|
idiopathic thrombocytopenia purpura |
no |
0 |
|
|
yes |
12 |
|
pulmonary hypertension |
no |
0 |
|
|
yes (mean > 30) |
11 |
|
cirrhosis |
no |
0 |
|
|
yes |
12.5 |
|
dialysis dependent |
no |
0 |
|
|
yes |
13.5 |
|
renal failure |
no |
0 |
|
|
yes (acute or chronic) |
3.5 |
|
abdominal aortic aneurysm, asymptomatic |
no |
0 |
|
|
yes |
0.5 |
|
carotid artery disease |
no |
0 |
|
|
yes (bilateral or 100% unilateral) |
2 |
|
peripheral vascular disease |
none to moderate |
0 |
|
|
severe |
3.5 |
|
blood products refused |
no |
0 |
|
|
yes |
11 |
|
severe neurologic disorder (healed CVA, paraplegia, muscular dystrophy, hemiparesis) |
no |
0 |
|
|
yes |
5 |
|
PTCA or catheterization failure |
no |
0 |
|
|
yes |
5.5 |
|
substance abuse |
no |
0 |
|
|
yes |
4.5 |
where:
• PTCA = percutaneous transluminal coronary angioplasty
subscore for special risk factors =
= SUM(points for all of the special risk factors)
Interpretation:
• minimum subscore: 0
• maximum subscore: 131.5
Specialty: Cardiology, Anesthesiology, Surgery, general
