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Model Predicting Perioperative Stroke in Patient Undergoing CABG Surgery

Purpose: To evaluate a patient prior to coronary artery bypass graft (CABG) surgery for risk of perioperative stroke based on the model of Charlesworth et al.

Description

Charlesworth et al developed a model for predicting the risk of perioperative stroke in a patient undergoing coronary artery bypass graft (CABG) surgery. This can help identify a patient who may benefit from closer monitoring and more aggressive management. The authors are from the Catholic Medical Center in Manchester, New Hampshire.


Parameters:

(1) age

(2) timing of surgery

(3) gender

(4) left ventricular ejection fraction

(5) history of vascular disease (stroke, transient ischemic attack, vascular surgery, carotid bruit, carotid stenosis, peripheral vascular disease, leg amputation or bypass surgery)

(6) diabetes mellitus

(7) preoperative renal disease (renal failure with dialysis or serum creatinine > 2 mg/dL)

 

Parameter

Finding

Points

age

< 60 years of age

0

 

60 - 69 years of age

1.5

 

70 to 79 years of age

2.5

 

>= 80 years of age

3.0

timing of surgery

elective

0

 

immediate (emergency)

1.5

 

within hours (urgent)

3.5

gender

male

0

 

female

1.5

ejection fraction

>= 40%

0

 

< 40%

1.5

vascular disease

absent

0

 

present

1.5

diabetes mellitus

absent

0

 

present

1.5

renal disease

absent

0

 

present

2.0

 

total score =

= SUM(points for all 7 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 14.5

• The higher the score the greater the risk of a perioperative stroke.

 

Total Score

Percent with Stroke

0 to 3

< 1%

4 or 5

1%

6

2%

7 or 8

3%

9

4%

10

6%

11

8%

>= 12

> 10%

 


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Specialty

Objective

ICD-10