現在 心臓血管術後管理におけるAF発症とStroke発症予防に対するJL-Knight Studyの他施設共同試験を企画中です。
この際に,ユーロスコアを合わせて評価する可能性がありますが,ユーロスコアとは心臓手術を受ける際の死亡率を予測スコアです。ヨーロッパ各国で集められたデータに基づいて導き出された結果解析であり,現在各国の心臓手術のリスク評価として用いられています。患者さんの術前状態を17項目でチェックして算出し,点数と一致して死亡率をパーセント表示します。
Patient-related factors
Score
1
Age
(per 5 years or part thereof over 60 years)
1
Sex
female
1
Chronic pulmonary disease
longterm use of bronchodilators or steroids for lung disease
2
Extracardiac arteriopathy
any one or more of the following: claudication, carotid occlusion or >50% stenosis, previous or planned intervention on the abdominal aorta,limb arteries or carotids
2
Neurological dysfunction disease
severely affecting ambulation or day-to-day functioning
3
Previous cardiac surgery
requiring opening of the pericardium
2
Serum creatinine
>200m micromol/L preoperatively
3
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: ventricular tachycardia or fibrillation or aborted sudden death, preoperative cardiac massage, preoperative ventilation before arrival in the anaesthetic room,preoperative inotropic support, intraaortic balloon counterpulsation or preoperative acute renal failure (anuria or oliguria<10 ml/hour)
Cardiac-related factors
2
Unstable angina
rest angina requiring iv nitrates until arrival in the anaesthetic room
1
LV dysfunction
moderate or LVEF30-50%
3
poor or LVEF <30
2
Recent myocardial infarct
(<90 days)
2
Pulmonary hypertension
Systolic PA pressure>60 mmHg
Operation-related factors
2
Operation-related factors Score
Emergency
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
3
Surgery on thoracic aorta
for disorder of ascending, arch or descending aorta
4
Postinfarct septal rupture
この際に,ユーロスコアを合わせて評価する可能性がありますが,ユーロスコアとは心臓手術を受ける際の死亡率を予測スコアです。ヨーロッパ各国で集められたデータに基づいて導き出された結果解析であり,現在各国の心臓手術のリスク評価として用いられています。患者さんの術前状態を17項目でチェックして算出し,点数と一致して死亡率をパーセント表示します。
Patient-related factors
Score
1
Age
(per 5 years or part thereof over 60 years)
1
Sex
female
1
Chronic pulmonary disease
longterm use of bronchodilators or steroids for lung disease
2
Extracardiac arteriopathy
any one or more of the following: claudication, carotid occlusion or >50% stenosis, previous or planned intervention on the abdominal aorta,limb arteries or carotids
2
Neurological dysfunction disease
severely affecting ambulation or day-to-day functioning
3
Previous cardiac surgery
requiring opening of the pericardium
2
Serum creatinine
>200m micromol/L preoperatively
3
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: ventricular tachycardia or fibrillation or aborted sudden death, preoperative cardiac massage, preoperative ventilation before arrival in the anaesthetic room,preoperative inotropic support, intraaortic balloon counterpulsation or preoperative acute renal failure (anuria or oliguria<10 ml/hour)
Cardiac-related factors
2
Unstable angina
rest angina requiring iv nitrates until arrival in the anaesthetic room
1
LV dysfunction
moderate or LVEF30-50%
3
poor or LVEF <30
2
Recent myocardial infarct
(<90 days)
2
Pulmonary hypertension
Systolic PA pressure>60 mmHg
Operation-related factors
2
Operation-related factors Score
Emergency
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
3
Surgery on thoracic aorta
for disorder of ascending, arch or descending aorta
4
Postinfarct septal rupture