Belov et al reported a score for predicting the risk of abdominal complications following coronary artery bypass graft (CABG) surgery. This can help to identify a patient who may require more aggressive management. The authors are from South Ural State Medical University and the Federal Center of Cardiovascular Surgery of the Ministry of Health of Russia.
Patient selection: CABG surgery
Outcome: any of the following with onset after surgery - acute cholecystitis, acute pancreatitis, acute mesenteric ischemia, intestinal necrosis, acute intestinal obstruction
Parameters:
(1) multifocal atherosclerosis
(2) extracorporeal membrane oxygenation (ECMO)
(3) intra-aortic balloon pump (IABP)
(4) atrial fibrillation in the postoperative period
(5) perioperative myocardial infarction (AMI)
(6) need to perform postoperative resternotomy (including use of ECMO)
|
Parameter
|
Finding
|
Points
|
|
multifocal atherosclerosis
|
absent
|
0
|
|
|
present
|
3
|
|
ECMO
|
no
|
0
|
|
|
yes
|
10
|
|
IABP
|
no
|
0
|
|
|
yes
|
6
|
|
atrial fibrillation
|
absent
|
0
|
|
|
present
|
5
|
|
perioperative AMI
|
absent
|
0
|
|
|
present
|
4
|
|
postoperative resternotomy
|
no
|
0
|
|
|
yes
|
7
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 35
|
Score
|
Percent with Complications
|
|
0
|
0.4%
|
|
1 to 6
|
1.2%
|
|
7 to 12
|
9.4%
|
|
>= 13
|
44%
|
Performance:
• The area under the ROC curve is 0.81
