II. Background
- Risk calculation is based on outcomes from contrast exposure with Percutaneous Coronary Intervention (PCI)
III. Criteria: Risk Factors
- Points 5: Congestive Heart Failure
- NYHA Class III or IV or
- Pulmonary Edema history
- Points 5: Hypotension
- Systolic Blood Pressure <80 mmHg for greater than one hour and
- Required inotropic medication support or intra-aortic balloon pump
- Points 5: Intra-Aortic Balloon Pump
- Points 4: Age over 75 years old
- Points 3: Anemia
- Men: Baseline Hematocrit <39%
- Women: Baseline Hematocrit <36%
- Points 3: Diabetes Mellitus
- Points ?: Contrast Media Volume
- Assign 1 point for every 100 ml of Contrast Media administered
- Points ?: Decreased GFR <60 ml/min/1.73m2
- Assign 2 points for eGFR 40-60 ml/min/1.73m2
- Assign 4 points for eGFR 20-40 ml/min/1.73m2 (or Creatinine Clearance >1.5 mg/dl)
- Assign 6 points for eGFR 20-40 ml/min/1.73m2
IV. Interpretation
- Total risk score 5 or less
- Contrast-Induced Nephropathy risk: 7.5%
- Dialysis risk: 0.04%
- Mortality risk (one year): 1.9%
- Total risk score 6 to 10
- Contrast-Induced Nephropathy risk: 14.0%
- Dialysis risk: 0.12%
- Mortality risk (one year): 5.5%
- Total risk score 11 to 15
- Contrast-Induced Nephropathy risk: 26.1%
- Dialysis risk: 1.09%
- Mortality risk (one year): 15.5%
- Total risk score 16 or more
- Contrast-Induced Nephropathy risk: 57.3%
- Dialysis risk: 12.6%
- Mortality risk (one year): 31.2%