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Score of Thakar et al for Predicting Acute Renal Failure After Cardiac Surgery

Purpose: To evaluate a patient who is undergoing cardiac surgery for the risk of developing acute renal failure after surgery using the score of Thakar et al.

Description

Thakar et al developed a score for predicting the risk of acute renal failure after cardiac surgery. This can help identify patients who should be monitored more closely and who may benefit from early interventions. The authors are from the Cleveland Clinic and the University of Cincinnati in Ohio.


Parameters:

(1) gender

(2) congestive heart failure

(3) left ventricular ejection fraction

(4) COPD

(5) diabetes mellitus

(6) history of previous cardiac surgery

(7) status of surgical need

(8) preoperative use of intra-aortic balloon pump (IABP)

(9) type of cardiac surgery

(10) preoperative serum creatinine

 

Parameter

Finding

Points

gender

male

0

 

female

1

congestive heart failure

absent

0

 

present

1

left ventricular ejection fraction

>= 35%

0

 

< 35%

1

COPD

absent

0

 

present

1

insulin dependent diabetes mellitus

absent

0

 

present

1

history of previous cardiac surgery

absent

0

 

present

1

status of surgical need

nonemergency

0

 

emergency

2

preoperative use of IABP

no

0

 

yes

2

type of cardiac surgery

CABG only

0

 

valve surgery only

1

 

CABG plus valve

2

 

other cardiac surgery

2

preoperative serum creatinine

< 1.2 mg/dL

0

 

1.2 - 2.09 mg/dL

2

 

>= 2.1 mg/dL

5

 

total score =

= SUM(points for all 10 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 17

 

Total Score

Probability Acute Renal Failure and Dialysis

0 - 2

0.4%

3 - 5

2%

6 - 8

8-10%

9 - 13

21%

14 - 17

NA

from Table 5


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Specialty

Objective

ICD-10