Zainab et al reported a score for predicting respiratory failure in a patient who has undergone cardiac surgery. This can help to identify a patient who may benefit from more aggressive management. The authors are from Houston Methodist Hospital.
Patient selection: cardiac surgery
Outcome: respiratory failure
Parameters:
(1) body mass index (BMI)
(2) diabetes
(3) chronic lung disease
(4) home oxygen
(5) recent pneumonia
(6) eGFR in mL per min per 1.73 square meter
(7) previous cardiac intervention
(8) NYHA classification
(9) cardiopulmonary bypass
(10) cardiogenic shock
(11) mechanical support
(12) total number of blood product units used
(13) ASA score
|
Parameter |
Finding |
Beta-Coefficient |
Points |
|
body mass index |
< 30 kg per sq m |
0 |
0 |
|
|
>= 30 |
0.32 |
5 |
|
diabetes |
no |
0 |
0 |
|
|
yes |
0.18 |
3 |
|
chronic lung disease |
no |
0 |
0 |
|
|
yes |
0.36 |
5 |
|
home oxygen |
no |
0 |
0 |
|
|
yes |
0.47 |
7 |
|
recent pneumonia |
no |
0 |
0 |
|
|
yes |
0.30 |
4 |
|
eGFR |
>= 60 |
0 |
0 |
|
|
< 60 |
0.53 |
8 |
|
cardiac intervention |
no |
0 |
0 |
|
|
yes |
0.40 |
6 |
|
NYHA class |
1 or 2 |
0 |
0 |
|
|
3 or 4 |
0.60 |
9 |
|
CP bypass |
no |
0 |
0 |
|
|
yes |
0.47 |
7 |
|
cardiogenic shock |
no |
0 |
0 |
|
|
yes |
1.21 |
17 |
|
mechanical support |
no |
0 |
0 |
|
|
yes |
0.53 |
8 |
|
blood products |
none |
0 |
0 |
|
|
|
0.09 * (number) |
(number) |
|
ASA score |
1 to 3 |
0 |
0 |
|
|
4 or 5 |
0.07 |
1 |
value of X =
= SUM(beta-coefficients for all of the parameters) - 3.20119
probability of respiratory failure =
= 1 / (1 + EXP((-1) * X))
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 81
|
Score |
Risk Group |
|
0 to 15 |
low |
|
16 to 25 |
moderate |
|
>- 26 |
high |
Performance:
• The area under the ROC curve is 0.73.
Specialty: Pulmonology
