Risk Score of Andersson et al for Predicting 30-Day Mortality for a Patient with Heart Failure Undergoing Non-Cardiac Surgery

Description

Andersson et al developed a score for predicting 30-day mortality for a patient with heart failure who is undergoing non-cardiac surgery. This can help to identify a patient who may benefit from more aggressive or alternative management. The authors are from multiple universities in Denmark, Sweden, and the United States.

Patient selection: adult with heart failure, undergoing non-cardiac surgery

Outcome: 30-day mortality

Parameters:

(1) gender

(2) age in years

(3) body mass index (BMI) in kilograms per square meter

(4) acute surgery

(5) high-risk procedure (intraperitoneal, intrathoracic, suprainguinal vascular surgery)

(6) renal disease

(7) cerebrovascular disease

(8) insulin therapy (presumably diabetes)

Parameter	Finding	Points
gender	female	0
	male	1
age	<= 55 years	0
	56 to 65 years	2
	66 to 75 years	4
	76 to 85 years	5
	> 85 years	7
body mass index	< 18.5 (underweight)	4
	18.5 to 24.9 (normal)	3
	25 to 29.9(overweight)	1
	>= 30 (obese)	0
acute surgery	no	0
	yes	5
high risk procedure	no	0
	yes	3
renal disease	no	0
	yes	1
cerebrovascular disease	no	0
	yes	1
insulin therapy	no	0
	yes	1

total score =

= SUM(points for all 8 parameters)

Interpretation:

• minimum score: 0

• maximum score: 23

• The higher the score the greater the risk of 30-day mortality.

Total Score	30-Day Mortality
0 to 4	< 2%
5 to 8	2-5%
9 to 11	5 to 10%
12 to 14	10 to 20%
15 or 16	20 to 30%
17 to 19	30 to 50%
20 to 23	> 50%

Performance:

• The area under the ROC curve is 0.79.

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Risk Score of Andersson et al for Predicting 30-Day Mortality for a Patient with Heart Failure Undergoing Non-Cardiac Surgery

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