Rao et al reported a score for predicting bleeding associated with percutaneous coronary intervention (PCI). This can help to identify patients who may benefit from more aggressive management. The study if from the National Cardiovascular Data Registry (NCDR) CathPCI Registry.
Patient selection: percutaneous coronary intervention (PCI)
Parameters:
(1) STEMI
(2) age in years
(3) body mass index (BMI)
(4) previous PCI
(5) chronic kidney disease
(6) shock
(7) cardiac arrest within 24 hours of the PCI
(8) gender
(9) hemoglobin in g/dL
(10) current PCI status
|
Parameter |
Finding |
Points |
|
STEMI |
no |
0 |
|
|
yes |
15 |
|
age in years |
< 60 |
0 |
|
|
60 to 70 |
10 |
|
|
71 to 79 |
15 |
|
|
>= 80 |
20 |
|
body mass index |
< 20 |
15 |
|
|
20 to 30 |
5 |
|
|
31 to 39 |
0 |
|
|
>= 40 |
5 |
|
previous PCI |
no |
10 |
|
|
yes |
0 |
|
chronic kidney disease |
no |
0 |
|
|
mild |
10 |
|
|
moderate |
25 |
|
|
dialysis |
30 |
|
shock |
no |
0 |
|
|
yes |
35 |
|
cardiac arrest |
no |
0 |
|
|
yes |
15 |
|
gender |
male |
0 |
|
|
female |
20 |
|
hemoglobin |
< 13 |
5 |
|
|
13 to 14.99 |
0 |
|
|
>=15 |
10 |
|
PCI status |
elective |
0 |
|
|
urgent |
20 |
|
|
emergency or salvage |
40 |
total score =
SUM(points for all 10 parameters)
Interpretation:
• minimum score: 0
• maximum score: 210
• The higher the score the greater the risk for bleeding.
|
Score |
Percent Bleeding |
|
0 to 25 |
1 – 2% |
|
25 to 100 |
(0.002456 * ((points)^2)) – (0.115 * (points)) + 3.622 |
|
100 to 150 |
(0.00368 * ((points)^2)) – (0.2756 * (points)) + 7.666 |
|
> 150 |
(-0.003692 * ((points)^2)) + (1.953 * (points)) – 161.2 |
Performance:
• The area under the curve (AUC) is 0.77.
Purpose: To identify a patient at risk for bleeding following percutanous coronary intervention (PCI) using the NCDR CathPCI bleeding risk score.
Specialty: Cardiology, Surgery, general
Objective: risk factors
ICD-10: I20-I25,
