cliot (version 1.0.0)

thakar_arf_cardiac_surgery: Acute Renal Failure after Cardiac Surgery (Thakar Score)

Description

Calculates the Thakar Score to predict the risk of Acute Renal Failure (ARF) requiring dialysis after open heart surgery. This scoring system uses preoperative variables to stratify patients into risk groups (Low, Moderate, High, Very High).

Usage

thakar_arf_cardiac_surgery(gender, chf, lvef_lt_35, preop_iabp, copd,
                           insulin_dependent_dm, prev_cardiac_surgery,
                           emergency_surgery, surgery_type, creatinine_mg_dl)

Value

A list containing:

Thakar_Score

The calculated score (Range 0-17).

Risk_Group

Risk classification group.

Est_Risk_Dialysis_Requirement

Predicted probability of requiring dialysis.

Arguments

gender

String. Patient gender ("Male" or "Female"). (Female +1 point).

chf

Numeric (0 or 1). Congestive Heart Failure. (1 = Yes, +1 point).

lvef_lt_35

Numeric (0 or 1). Left Ventricular Ejection Fraction < 35%. (1 = Yes, +1 point).

preop_iabp

Numeric (0 or 1). Preoperative Intra-Aortic Balloon Pump use. (1 = Yes, +2 points).

copd

Numeric (0 or 1). Chronic Obstructive Pulmonary Disease. (1 = Yes, +1 point).

insulin_dependent_dm

Numeric (0 or 1). Insulin-requiring Diabetes Mellitus. (1 = Yes, +1 point).

prev_cardiac_surgery

Numeric (0 or 1). History of previous cardiac surgery. (1 = Yes, +1 point).

emergency_surgery

Numeric (0 or 1). Surgery is emergent (required before next working day). (1 = Yes, +2 points).

surgery_type

String. Type of surgery. "cabg": CABG only (0 points). "valve": Valve only (+1 point). "cabg+valve": CABG + Valve (+2 points). "other": Other cardiac surgery (+2 points).

creatinine_mg_dl

Numeric. Preoperative serum creatinine in mg/dL. < 1.2: 0 points. 1.2 - 2.0: +2 points. >= 2.1: +5 points.

References

Thakar CV, Arrigain S, Worley S, Yared JP, Paganini EP. A clinical score to predict acute renal failure after cardiac surgery. J Am Soc Nephrol. 2005;16(1):162-168. doi:10.1681/ASN.2004040331

Examples

# Example 1: High Risk
# Female, Diabetic (Insulin), Cr 1.5, CABG+Valve
# Score = 1 (F) + 1 (DM) + 2 (Cr) + 2 (Surg) = 6 -> High Risk (7.0%)
thakar_arf_cardiac_surgery("female", 0, 0, 0, 0, 1, 0, 0, "cabg+valve", 1.5)

# Example 2: Low Risk
# Male, No comorbidities, Cr 0.9, CABG only
# Score = 0 -> Low Risk (0.4%)
thakar_arf_cardiac_surgery("male", 0, 0, 0, 0, 0, 0, 0, "cabg", 0.9)