Predictor | Definition | Risk points* |
Age | Per 5 years or part thereof over 60 years | 1 |
Sex | Female | 1 |
Chronic pulmonary disease | Long-term use of bronchodilators or steroids for lung disease | 1 |
Extracardiac arteriopathy | Any one or more of the following: | 2 |
claudication |
carotid occlusion or >50% stenosis |
previous or planned intervention on the abdominal aorta, limb arteries, or carotids |
Neurological dysfunction | Disease severely affecting ambulation or day-to-day functioning | 2 |
Previous cardiac surgery | Requiring opening of the pericardium | 3 |
Serum creatinine | >200 micromol/L (2.3 mg/dL) preoperatively | 2 |
Active endocarditis | Patient still under antibiotic treatment for endocarditis at the time of surgery | 3 |
Critical preoperative state | Any one or more of the following: | 3 |
ventricular tachycardia or fibrillation or aborted sudden death |
preoperative cardiac massage |
preoperative ventilation before arrival in the anesthetic room |
preoperative inotropic support |
intraaortic balloon counterpulsation |
preoperative acute renal failure (anuria or oliguria <10 mL/hour) |
Unstable angina | Rest angina requiring IV nitrates until arrival in the anesthetic room | 2 |
LV dysfunction | Moderate or LV ejection fraction 30 to 50% | 1 |
Poor or LV ejection fraction <30% | 3 |
Recent myocardial infarct | <90 days | 2 |
Pulmonary hypertension | Systolic pulmonary artery pressure >60 mmHg | 2 |
Emergency operation | Carried out on referral before the beginning of the next working day | 2 |
Other than isolated CABG | Major cardiac procedure other than or in addition to CABG | 2 |
Surgery on thoracic aorta | For disorder of ascending, arch or descending aorta | 3 |
Postinfarct septal rupture | | 4 |