II. Background

  1. Risk calculation is based on outcomes from contrast exposure with Percutaneous Coronary Intervention (PCI)

III. Criteria: Risk Factors

  1. Points 5: Congestive Heart Failure
    1. NYHA Class III or IV or
    2. Pulmonary edema history
  2. Points 5: Hypotension
    1. Systolic Blood Pressure <80 mmHg for greater than one hour and
    2. Required inotropic medication support or intra-aortic balloon pump
  3. Points 5: Intra-Aortic Balloon Pump
  4. Points 4: Age over 75 years old
  5. Points 3: Anemia
    1. Men: Baseline Hematocrit <39%
    2. Women: Baseline Hematocrit <36%
  6. Points 3: Diabetes Mellitus
  7. Points ?: Contrast Media Volume
    1. Assign 1 point for every 100 ml of Contrast Media administered
  8. Points ?: Decreased GFR <60 ml/min/1.73m2
    1. Assign 2 points for eGFR 40-60 ml/min/1.73m2
    2. Assign 4 points for eGFR 20-40 ml/min/1.73m2 (or Creatinine Clearance >1.5 mg/dl)
    3. Assign 6 points for eGFR 20-40 ml/min/1.73m2

IV. Interpretation

  1. Total risk score 5 or less
    1. Contrast-Induced Nephropathy risk: 7.5%
    2. Dialysis risk: 0.04%
    3. Mortality risk (one year): 1.9%
  2. Total risk score 6 to 10
    1. Contrast-Induced Nephropathy risk: 14.0%
    2. Dialysis risk: 0.12%
    3. Mortality risk (one year): 5.5%
  3. Total risk score 11 to 15
    1. Contrast-Induced Nephropathy risk: 26.1%
    2. Dialysis risk: 1.09%
    3. Mortality risk (one year): 15.5%
  4. Total risk score 16 or more
    1. Contrast-Induced Nephropathy risk: 57.3%
    2. Dialysis risk: 12.6%
    3. Mortality risk (one year): 31.2%

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