A risk index for adults undergoing cardiac surgery was developed at the centers in the Provincial Adult Cardiac Care Network (PACCN) of Ontario in Canada. The index correlates with the mortality, intensive care unit stay, and overall hospital length of stay after cardiac surgery.
Population: Adult patients undergoing cardiac surgery at heart centers in Canada.
Risk factors:
(1) age
(2) sex
(3) left ventricular function
(4) type of surgery
(5) urgency of operation
(6) repeat operation
|
Risk Factor |
Finding |
Points |
|---|---|---|
|
age in years |
< 65 |
0 |
|
|
65 - 74 |
2 |
|
|
>= 75 |
3 |
|
sex |
male |
0 |
|
|
female |
1 |
|
left ventricular function (ejection fraction) |
Grade 1 (> 50%) |
0 |
|
|
Grade 2 (35-50%) |
1 |
|
|
Grade 3 (20-34% |
2 |
|
|
Grade 4 (< 20%) |
3 |
|
type of surgery |
CABG only |
0 |
|
|
single valve |
2 |
|
|
complex |
3 |
|
urgency of operation |
elective |
0 |
|
|
urgent |
1 |
|
|
emergency |
4 |
|
repeat operation |
no |
0 |
|
|
yes |
2 |
risk index =
= SUM(points for the six risk factors)
Interpretation:
• minimum index: 0
• maximum index: 16
|
Risk Index |
Risk Group |
|
0 - 3 |
low |
|
4 - 7 |
intermediate |
|
>= 8 |
high |
|
Risk Score |
In- Hospital Mortality Rate |
Mean ICU Length of Stay |
Mean Post-Op Length of Stay |
|
0 |
0.52% |
2.33 days |
8.21 days |
|
1 |
1.16% |
2.60 days |
8.57 days |
|
2 |
1.39% |
2.77 days |
9.64 days |
|
3 |
2.71% |
3.05 days |
10.27 days |
|
4 |
4.01% |
3.14 days |
10.71 days |
|
5 |
5.38% |
3.77 days |
12.25 days |
|
6 |
5.76% |
4.61 days |
14.28 days |
|
7 |
10.43% |
4.46 days |
13.46 days |
|
>= 8 |
20.62% |
5.91 days |
16.88 days |
from Table 4, Tu et al (1995), for 1991 Derivation Set
Purpose: To assess the risk for an adult undergoing cardiac surgery using the PACCN risk index .
Specialty: Cardiology, Surgery, general
Objective: risk factors, severity, prognosis, stage, complications
ICD-10: I97.1,
