Mehta et al developed a bedside tool for identifying patients who are likely to develop renal failure requiring dialysis following cardiac surgery. The authors are from the Society of Thoracic Surgeons National Cardiac Surgery Database Investigators.
Parameters:
(1) last serum creatinine in mg/dL
(2) age in years
(3) type of surgery
(4) diabetes mellitus
(5) history of a recent myocardial infarction (AMI)
(6) race
(7) chronic lung disease
(8) history of previous cardiovascular surgery
(9) NYHA class
(10) presence of cardiogenic shock
Parameter |
Finding |
Points |
---|---|---|
last serum creatinine in mg/dL |
|
MIN(40, 10 * (serum creatinine)) |
age in years |
< 55 years of age |
0 |
|
55 to 59 years |
1 |
|
60 to 64 years |
2 |
|
65 to 69 years |
3 |
|
70 to 74 years |
4 |
|
75 to 79 years |
5 |
|
80 to 84 years |
6 |
|
85 to 89 years |
7 |
|
90 to 94 years |
8 |
|
95 to 99 years |
9 |
|
>= 100 years |
10 |
type of surgery |
CABG only |
0 |
|
aortic valve only |
2 |
|
mitral valve only |
4 |
|
CABG and aortic valve |
5 |
|
CABG and mitral valve |
7 |
diabetes |
none |
0 |
|
oral control |
2 |
|
insulin required |
5 |
recent MI |
none |
0 |
|
within past 3 weeks |
3 |
race |
White |
0 |
|
non-White |
2 |
chronic lung disease |
absent |
0 |
|
present |
3 |
previous cardiac surgery |
no |
0 |
|
yes |
3 |
NYHA class |
I, II or III |
0 |
|
IV |
3 |
cardiogenic shock |
absent |
0 |
|
present |
7 |
total score =
= SUM(points for all 10 parameters)
Interpretation:
• minimum score: 0
• maximum score: 83
• The higher the score the greater the risk for renal failure.
Total Score |
Risk of Dialysis in Percent |
---|---|
< 12 |
0.2% |
12 to 22 |
(0.01205 * ((score)^2)) - (0.2912 * (score)) + 2.077 |
22 to 42 |
(0.03109 * ((score)^2)) - (1.108 * (score)) + 10.78 |
43 |
19% |
44 to 68 |
(0.05091 * ((score)^2)) - (3.157 * (score)) + 58.85 |
Purpose: To predict the risk of acute renal failure requiring dialysis following cardiac surgery using the bedside tool of Mehta et al.
Specialty: Anesthesiology, Nephrology
Objective: risk factors, clinical diagnosis, including family history for genetics
ICD-10: Z48, Y84,