Mackie et al developed a Clinical Outcome Score (COS) for predicting psychomotor developmental problems in infants following cardiopulmonary bypass surgery for congenital heart disease. The authors are from the University of Alberta, Stollery Children’s Hospital in Edmonton, Glenrose Rehabilitation Hospital, Lucile Packard Children’s Hospital, Stanford University, Children’s Hospital Boston and Harvard University.
Patient selection: infant with congenital heart disease requiring cardiopulmonary bypass surgery
Outcome: Psychomotor Developmental Index (PDI) of the Bayley Scales of Infant Development (BSID-II)
Parameters:
(1) time to first negative fluid balance in days
(2) time until sternal closure in days
(3) time until first extubation in days
(4) death or use of ECMO
Original (2005)
|
Parameter |
Finding |
Points |
|
time to first negative fluid balance |
<= 3 days |
0 |
|
|
4 to 5 days |
1 |
|
|
>= 6 days |
2 |
|
time until sternal closure |
<= 2 days |
0 |
|
|
3 to 4 days |
1 |
|
|
>= 5 days |
2 |
|
time until first extubation |
<= 4 days |
0 |
|
|
5 to 8 days |
1 |
|
|
>= 9 days |
2 |
|
death or ECMO |
no |
0 |
|
|
yes |
7 |
Modified (2013)
|
Parameter |
Finding |
Points |
|
time to first negative fluid balance |
<= 1 days |
0 |
|
|
2 days |
1 |
|
|
>= 3 days |
2 |
|
time until sternal closure |
<= 1 days |
0 |
|
|
2 to 4 days |
1 |
|
|
>= 5 days |
2 |
|
time until first extubation |
<= 4 days |
0 |
|
|
5 to 8 days |
1 |
|
|
>= 9 days |
2 |
|
death or ECMO |
no |
0 |
|
|
yes |
7 |
COS =
= MAX(points for death or ECMO, SUM(first 3 parameters)
Interpretation:
• minimum COS: 0
• maximum COS: 7
• A modified COS >= 3 is associated with lower Psychomotor Developmental Index (PDI).
Specialty: Anesthesiology, Neurology, Surgery, orthopedic
