Index of Easterlin et al for Predicting 30-Day Mortality After a Major Amputation

Description

Easterlin et al reported an index for predicting mortality in patients undergoing a major amputation. This index can help to identify a patient who may benefit from a more aggressive management. The authors are from the University of California San Diego and University of California Irvine.

Patient selection: major amputation (above the knee, below the knee, other lower extremity amputations)

Outcome: 30-day mortality (occurred in 8.1% of 9,244 patients)

Parameters:

(1) age in years

(2) steroid use

(3) functional status

(4) dialysis

(5) dyspnea

(6) history of congestive heart failure (CHF)

(7) history of COPD

(8) impaired sensorium

(9) preoperative sepsis

(10) history of previous cardiac surgery

Parameter	Finding	Points
age in years	< 60 years	0
	60 to 79 years	1
	>= 80 years	2
steroid use	no	0
	yes	1
functional status	non dependent	0
	dependent	2
dialysis	no	0
	yes	2
dyspnea	no	0
	yes	1
history of CHF	no	0
	yes	1
history of COPD	no	0
	yes	1
impaired sensorium	no	0
	yes	1
preoperative sepsis	no	0
	yes	1
previous cardiac surgery	no	0
	yes	1

total score =

= SUM(points for all 10 parameters)

Interpretation:

• minimum score: 0

• maximum score: 13

• The higher the score the greater the mortality.

Score	30-Day Mortality
0	0.3%
1	1%
2	3%
3	5%
4	8%
5	10%
6	20%
7	20%
8	29%
9	33%
10	39%
> 10	> 40%

Performance:

• The area under the ROC curve was 0.74.

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Index of Easterlin et al for Predicting 30-Day Mortality After a Major Amputation

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