Zheng et al reported the SinoSCORE for predicting in-hospital mortality following coronary artery bypass graft (CABG) surgery in a Chinese patient. This can help to identify a patient who may benefit from more aggressive management. The authors are from the Chinese CABG Registry.
Patient selection: Chinese patient undergoing CABG
Parameters:
(1) age of the patient in years
(2) body mass index in kilograms per square meter
(3) chronic renal failure (past history or serum creatinine > 176 µmol/L)
(4) extracardiac arteriopathy (one or more of the following: claudication, carotid occlusion or stenosis >= 50%, previous or planned vascular surgery on abdominal aorta, carotid or limb arteries = peripheral arterial disease)
(5) COPD with long-term use of bronchodilators or steroids
(6) NYHA stage
(7) preoperative atrial fibrillation or flutter in the past 2 weeks
(8) left ventricular ejection fraction prior to surgery in percent
(9) preoperative critical factors (one or more of the following: preoperative cardiogenic shock, ventricular fibrillation, ventricular flutter, preoperative IABP implantation)
(10) surgical acuity
(11) combined valve surgery
|
Parameter
|
Finding
|
Points
|
|
age in years
|
< 65 years
|
0
|
|
|
65 to 69
|
3
|
|
|
70 to 74
|
5
|
|
|
>= 75 years
|
6
|
|
BMI
|
< 18
|
5
|
|
|
18 to 23.9
|
0
|
|
|
>= 24
|
-2
|
|
CRF
|
absent
|
0
|
|
|
present
|
6
|
|
extracardiac arteriopathy
|
absent
|
0
|
|
|
present
|
5
|
|
COPD
|
absent
|
0
|
|
|
present
|
4
|
|
NYHA stage
|
I or II
|
0
|
|
|
III
|
3
|
|
|
IV
|
7
|
|
atrial fibrillation/flutter
|
absent
|
0
|
|
|
present
|
2
|
|
ejection fraction
|
>= 50%
|
0
|
|
|
< 50%
|
4
|
|
preoperative critical factors
|
absent
|
0
|
|
|
present
|
4
|
|
surgical acuity
|
elective
|
0
|
|
|
non-elective
|
5
|
|
combined with valve surgery
|
no
|
0
|
|
|
yes
|
4
|
total score =
= SUM(points for all 11 parameters)
Interpretation:
• minimum score: -2
• maximum score: 52
• The higher the score the greater the in-hospital mortality.
Performance:
• The area under the ROC curve was 0.80 in the derivation cohort and 0.78 in the validation cohort.
