Wang et al reported a nomogram for predicting postoperative hyperlactatemia based on findings seen after cardiac surgery. This can help to recognize a patient who may require more aggressive management. The authors are from multiple institutions in Wuhan, China.
Patient selection: status post elective cardiac surgery
Parameters:
(1) age in years, from 15 to 85
(2) renal insufficiency
(3) history of previous cardiac surgery
(4) left ventricular ejection fraction (LVEF) in percent, from 25 to 80 percent
(5) intraoperative RBC transfusion in units, from 0 to 12
(6) cardiopulmonary bypass time in minutes, from 22 to 294
points for age =
= (0.793 * (age)) - 9.892
points for LVEF =
= 116.089 - (1.384 * (percent))
points for RBC transfusion =
= (5.324 * (units)) + 20.74
points for time on cardiopulmonary bypass =
= (0.368 * (minutes)) - 8.088
|
Parameter
|
Finding
|
Points
|
|
renal insufficiency
|
no
|
30.908
|
|
|
yes
|
50.309
|
|
previous cardiac surgery
|
no
|
30.774
|
|
|
yes
|
62.418
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 89.780
• maximum score: 436.373
value of X =
= (0.03589 * (score)) - 9.43
probability of hyperlactatemia =
= 1 / ( 1 + EXP((-1) * X))
