cliot (version 1.0.0)

mehran_score_cin: Mehran Score for Post-PCI Contrast-Induced Nephropathy (CIN)

Description

Calculates the Mehran Risk Score to predict the risk of Contrast-Induced Nephropathy (CIN) and the need for dialysis following Percutaneous Coronary Intervention (PCI). The score uses clinical factors (hypotension, IABP, CHF, age, diabetes, anemia), contrast volume, and renal function (Serum Creatinine or eGFR).

Usage

mehran_score_cin(hypotension, intraaortic_balloon_pump, congestive_heart_failure,
                 age_gt_75, diabetes, anemia, contrast_volume_cc,
                 serum_creatinine_mg_dl = NULL, egfr_ml_min = NULL)

Value

A list containing:

Mehran_Score

The calculated risk score (Range 0-~30+).

Risk_Class

Classification (Low, Moderate, High, Very High).

Risk_CIN

Estimated probability of developing CIN (>= 25% rise or >= 0.5 mg/dL increase in SCr).

Risk_Dialysis

Estimated probability of requiring dialysis.

Arguments

hypotension

Numeric (0 or 1). SBP < 80 mmHg for > 1 hour requiring inotropes or IABP support. (1 = Yes, +5 pts).

intraaortic_balloon_pump

Numeric (0 or 1). Use of IABP. (1 = Yes, +5 pts).

congestive_heart_failure

Numeric (0 or 1). CHF Class III/IV or history of pulmonary edema. (1 = Yes, +5 pts).

age_gt_75

Numeric (0 or 1). Age > 75 years. (1 = Yes, +4 pts).

diabetes

Numeric (0 or 1). History of diabetes. (1 = Yes, +3 pts).

anemia

Numeric (0 or 1). Baseline hematocrit < 39% for men or < 36% for women. (1 = Yes, +3 pts).

contrast_volume_cc

Numeric. Total volume of contrast media used in cc (mL). (1 point per 100 cc).

serum_creatinine_mg_dl

Numeric (Optional). Baseline Serum Creatinine in mg/dL. (> 1.5 mg/dL adds 4 pts). Note: Original score used SCr; updated versions often incorporate eGFR.

egfr_ml_min

Numeric (Optional). Estimated GFR in mL/min/1.73m^2. Used if Serum Creatinine is not provided for more granular scoring (20-40: +4, 40-60: +2, <20: +6).

References

Mehran R, Aymong ED, Nikolsky E, et al. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J Am Coll Cardiol. 2004;44(7):1393-1399. doi:10.1016/j.jacc.2004.06.068

Examples

# Example 1: High Risk
# Hypotension (+5), Diabetes (+3), Contrast 250cc (+2), SCr 1.8 (+4)
# Score = 14
mehran_score_cin(1, 0, 0, 0, 1, 0, 250, serum_creatinine_mg_dl = 1.8)

# Example 2: Low Risk
# Age 50 (0), Contrast 100cc (+1), Normal SCr (0), No other factors
# Score = 1
mehran_score_cin(0, 0, 0, 0, 0, 0, 100, serum_creatinine_mg_dl = 0.9)