CABG Surgery Prognosis Risk Score - Medical Algorithm

Description

Patients at risk for morbidity and mortality following coronary artery bypass graft (CABG) surgery can be identified using a clinical risk score developed at Allegheny General Hospital in Pittsburgh.

NOTE: The score appears to apply to patients having bypass graft surgery only and not concurrent valve surgery.

Parameter	Finding	Points
age	< 65 years	0
	65 - 69 years	1
	70 - 74 years	2
	>= 75 years	3
gender	male	0
	female	1
operation timeliness	elective	0
	urgent	4
	emergency	5
reoperation	no	0
	yes	1
diabetes mellitus	non-insulin dependent	1
	insulin dependent	2
renal dysfunction	creatinine 1.5 - 1.9 mg/dL	1
	creatinine > 1.9 mg/dL	2
left ventricular dysfunction	ejection fraction >= 30%	0
	severe (ejection fraction < 30%)	4
serum albumin	>= 4.0 g/dL	0
	< 4 g/dL (paper says < 4 mg/dL which seems an error)	1
BUN	<= 29 mg/dL	0
	> 29 mg/dL	1

Additional Risk Factors	Points
cardiogenic shock	7
congestive heart failure	1
cardiomegaly	2
atrial arrhythmia	1
catheterization induced coronary closure	4
peripheral vascular disease	2
cerebrovascular disease	1
anemia	1
chronic obstructive pulmonary disease	1
low body mass index	1

clinical risk score =

= SUM(points for parameters) + SUM(points for additional risk factors)

Interpretation:

• minimum score: 0

• maximum score: 41 (20 + 21)

Clinical Risk Score	Mortality Risk	Percent Predicted
0 - 4	low	0.2%
5 - 8	average	2%
9 - 11	moderate	6%
12 - 18	high	30%
>= 19	extremely high	95%

(Table 3 and Figure 1, page 1150)

Clinical Risk Score	Morbidity Risk	Percent Predicted
0 - 2	low	20%
3 - 5	moderate	50%
6 - 8	high	74%
>= 9	extremely high	93%

(Table 3 and Figure 2, page 1150)

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Description

Specialty

Objective

ICD-10

The Clinical Risk Score of Magovern et al for Patients Having Coronary Artery Bypass Graft (CABG) Surgery

Purpose: To use a clinical risk score to estimate the risk for morbidity and mortality in a patient undergoing coronary artery bypass graft (CABG) surgery.

Description

Specialty

Objective

ICD-10