A prognostic score for adult patients having open heart surgery was developed at French cardiac surgery centers.
Features of the French score:
(1) Component factors were selected by multivariate analysis.
(2) Factors shared with the Parsonnet system: age, ejection fraction, reoperation, valve added to coronary bypass procedure.
(3) Factors from Parsonnet scoring system not used: age, hypertension, left ventricular aneurysm, intra-aortic balloon pump, morbid obesity, mitral and aortic valve surgery.
(4) Variables not used due to variation between centers or difficulty in defining clearly: unstable angina, peripheral vascular disease, chronic pulmonary obstructive disease, congestive heart failure.
Risk Factor |
Finding |
Points |
---|---|---|
age in years |
< 70 |
0 |
|
70-74 |
3 |
|
75-79 |
4 |
|
>= 80 |
5 |
chronic renal failure |
absent |
0 |
|
creatinine >= 200 µmol/L and not on dialysis |
5 |
|
patient on dialysis |
6 |
ejection fraction |
> 50% |
0 |
|
31 – 50% |
2 |
|
<= 30% |
5 |
saphenous vein graft only |
no |
0 |
|
yes |
2 |
reoperation |
no |
0 |
|
yes |
2 |
tricuspid valve surgery |
no |
0 |
|
yes |
4 |
valve (mitral or aortic) and (coronary artery bypass graft) CABG |
no |
0 |
|
yes |
2 |
where:
• The internal mammary artery was preferred over the saphenous vein for coronary artery bypass procedures, with the saphenous vein graft used in emergency or higher risk patients.
Type of Critical Situations |
Points |
myocardial infarction < 48 hours prior to surgery |
4 |
ventricular tachycardia or fibrillation |
4 |
preoperative intubation |
10 |
cardiac transplantation |
9 |
post-MI ventricular septal defect (VSD) |
8 |
acute aortic dissection |
13 |
pulmonary embolectomy |
15 |
French score =
= (points for risk factors) + (points for critical situations)
Interpretation:
• Minimum score: 0
• Maximum score: > 50
French Score |
Mortality Rate |
< 2 |
2% |
2-3 |
3.9% |
4-6 |
6.1% |
> 6 |
21.2% |
after Figure 1, page 435
Limitations:
• Scores much higher than 6 would be expected to have a higher mortality rate than that shown.
Purpose: To predict operative mortality in adults undergoing open heart surgery using the prognostic score developed in France.
Specialty: Cardiology, Surgery, general
Objective: risk factors, severity, prognosis, stage, complications
ICD-10: I97.1,