Brown et al reported a simple score for predicting the risk of serious renal dysfunction after percutaneous coronary intervention (PCI). The authors are from Dartmouth-Hitchcock Medical Center, Catholic Health Center Manchester, Eastern Maine Medical Center, Maine Medical Center and Fletcher Allen Health Care.
Patient selection: PCI with contrast
Outcome: serious contrast-related renal dysfunction (new onset of dialysis; >= 2 mg/dL OR >= 50% increase in serum creatinine from baseline)
Parameters:
(1) age in years
(2) sex
(3) diabetes
(4) acuity
(5) congestive heart failure (CHF)
(6) serum creatinine
(7) intra-aortic balloon pump (IABP) prior to PCI
Parameter
Finding
Points
age in years
< 80 years
0
>= 80 years
2
sex
male
0
female
2
diabetes
no
0
yes
3
acuity
emergent
3.5
urgent
2.5
other
0
congestive heart failure
no
0
yes
4.5
serum creatinine
< 1.3 mg/dL
0
1.3 to 1.9 mg/dL
5
>= 2.0
10
pre-PCI IABP
no
0
yes
13
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 38
• The higher the score the greater the risk of serious renal disease.
Score
Percent Serious Renal Dysfunction
0 to 5
0
6 or 7
< 1%
8 or 9
1%
10 to 14
6%
15 to 19
9.3%
>= 20
>= 22%
Performance:
• The area under the ROC curve is 0.87.
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