_id

683a162ec782e11e38d1b254

id

10075

title

ACEF II Risk Score for Cardiac Surgery

full_title

ACEF II Risk Score for Cardiac Surgery

short_title

ACEF II Risk Score

med_description

Predicts 30-day mortality after elective or emergency cardiac surgery.

short_description

Cardiac surgery mortality.

slug

acef-ii-risk-score-cardiac-surgery

description

The ACEF II Risk Score for Cardiac Surgery predicts the 30-day mortality risk score for elective cardiac surgery, including emergency surgery and pre-operative anaemia risk factor.

keywords

ACEF II Risk Score, ACEF, cardiac surgery, 30-day mortality, cardiac risk, emergency surgery, pre-op anaemia

complaint

[ "Chest Pain" ]

formula

ACEF II = (A / EF) + C + Em + Hct, where variables are as follows:

evidence

measurements

[ { "name": "Age", "unit": "age", "error_min": "0.001", "error_max": "120", "warn_min": "0.1", "warn_max": "100", "conversion": "1", "normal_max_si": "0", "normal_max_us": "0", "normal_min_si": "0", "normal_min_us": "0", "units_si": "years", "units_us": "years" }, { "name": "Hematocrit", "unit": "hct", "error_min": "1", "error_max": "70", "warn_min": "20", "warn_max": "55", "conversion": "1", "normal_max_si": "51", "normal_max_us": "51", "normal_min_si": "36", "normal_min_us": "36", "units_si": "%", "units_us": "%" }, { "name": "% Neutrophils", "unit": "neut", "error_min": "-0.01", "error_max": "100.01", "warn_min": "35", "warn_max": "100", "conversion": "1", "normal_max_si": "0", "normal_max_us": "0", "normal_min_si": "0", "normal_min_us": "0", "units_si": "%", "units_us": "%" } ]

information

Interpetation: 

Predicted 30-day operative mortality = e^x / (1 + e^x)

where x = -4.86 + 0.75 x ACEF II

refrences

{ "Clinical Practice Guidelines": [ { "href": "", "text": "" } ], "Manufacturer Website": [ { "href": "", "text": "" } ], "Original/Primary Reference": [ { "href": "https://www.ncbi.nlm.nih.gov/pubmed/28498904 ", "text": "Ranucci M, Pistuddi V, Scolletta S, De vincentiis C, Menicanti L. The ACEF II Risk Score for cardiac surgery: updated but still parsimonious. Eur Heart J. 2018;39(23):2183-2189." } ], "Other References": [ { "href": "https://www.ncbi.nlm.nih.gov/pubmed/24401691 ", "text": "Barili F, Pacini D, Rosato F, et al. In-hospital mortality risk assessment in elective and non-elective cardiac surgery: a comparison between EuroSCORE II and age, creatinine, ejection fraction score. Eur J Cardiothorac Surg. 2014;46(1):44-8." }, { "href": "https://www.ncbi.nlm.nih.gov/pubmed/28825573 ", "text": "Borracci RA, Rubio M, Baldi J, Ingino CA, Barisani JL. Validation of age, creatinine and ejection fraction (ACEF) and Cockcroft-Gault ACEF scores in elective cardiac surgery. Medicina (B Aires). 2017;77(4):297-303." } ], "Outcomes": [ { "href": "", "text": "" } ], "Validation": [ { "href": "", "text": "" } ], "Validations": [] }

pearls

• This tool is based on the 2018 updated version of the original Age, Creatinine, and Ejection Fraction (ACEF) score, which now includes emergency surgery, anemia, and remodulated coefficients.
• Unlike other generalized preoperative risk assessment tools, this calculator is derived specifically from a population of individuals who underwent cardiac surgery.
• Does not account for all potential risk factors, such as frailty, pulmonary disease, or detailed procedural risks, and may underestimate risk in patients with other significant comorbidities.
• Best used in combination with clinical judgment and other risk assessment tools for a comprehensive evaluation.

usecase

Use during preoperative risk assessment in patients undergoing elective, urgent, or emergent cardiac surgery.

reasons

Provides a quick and validated estimate of 30-day operative mortality risk. Helps facilitate shared decision-making between clinicians and patients by clarifying risk profiles.

next_advice

• Discuss the calculated risk with the patient and surgical team to align expectations and make informed decisions.
• Prioritize perioperative optimization, such as improving renal function or addressing modifiable cardiac risk factors.
• Integrate the score into broader multidisciplinary decision-making, particularly for high-risk patients or those requiring complex procedures.
• This tool should not be the sole measure of perioperative risk. Consider the implication of other clinical variables and comorbidities (e.g., baseline pulmonary function, liver impairment).

next_actions

next_management

diseases

[ "Acute Coronary Syndrome", "CHF", "Endocarditis", "Heart Failure", "Myocardial Infarction" ]

input_schema

[ { "conditionality": "", "default": null, "fhir_rules": null, "inct": null, "label_en": "Age", "name": "age", "optional": false, "tips_en": "", "type": "textbox", "unit": "age" }, { "conditionality": "", "default": null, "fhir_rules": null, "inct": null, "label_en": "Ejection fraction", "name": "ef", "optional": false, "tips_en": "On most recent assessment", "type": "textbox", "unit": "neut" }, { "conditionality": "", "default": 0, "label_en": "<p>Creatinine</p>", "mdcalc_info_concept": null, "name": "creat", "option_fhir_rules": null, "optional": false, "options": [ { "label": "≤2.0 mg/dL (177 µmol/L)", "value": 0 }, { "label": ">2.0 mg/dL (177 µmol/L)", "value": 2 } ], "show_points": false, "tips_en": "Last recorded value before surgery", "type": "radio" }, { "conditionality": "", "default": 0, "label_en": "<p>Emergency surgery</p>", "md_calc_info_concept": null, "name": "emsurg", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 3 } ], "show_points": false, "tips_en": "Emergency = operation required before the beginning of the next working day after decision to operate", "type": "toggle" }, { "conditionality": "", "default": null, "fhir_rules": null, "inct": null, "label_en": "Hematocrit", "name": "hematocrit", "optional": false, "tips_en": "Last recorded value before surgery", "type": "textbox", "unit": "hct" } ]

instructions

published

2022-04-21T20:28:14.391Z

purpose

[ "Prognosis" ]

search_terms

[ "ACEF II risk score", "acef 2", "acef score", "cardiac surgery risk score", "ACEF risk score", "ACEF" ]

seo

{ "keywords_en": "ACEF II Risk Score, ACEF, cardiac surgery, 30-day mortality, cardiac risk, emergency surgery, pre-op anaemia ", "meta_description_en": "The ACEF II Risk Score for Cardiac Surgery predicts the 30-day mortality risk score for elective cardiac surgery, including emergency surgery and pre-operative anaemia risk factor. " }

specialty

[ "Cardiology", "Critical Care", "Emergency Medicine", "Family Practice", "Hospitalist Medicine", "Internal Medicine", "Primary Care", "Surgery (Cardiothoracic)" ]

departments

[ "Cardiac" ]

tags

[]

version_number

1

versions

[]

related

[ { "calcId": 10471, "short_title_en": "Thakar Score", "slug": "acute-renal-failure-cardiac-surgery-thakar-score" }, { "calcId": 10499, "short_title_en": "SCORE2", "slug": "systematic-coronary-risk-evaluation-score2" }, { "calcId": 10510, "short_title_en": "SCORE2-Diabetes", "slug": "score2-diabetes" } ]

ismed

false

section

[ "whenToUseViewed", "pearlsPitfallsViewed", "whyUseViewed", "nextStepsViewed", "evidenceViewed" ]

cleaned_departments

[ "cardiology" ]

cleaned_use

[ "Use during preoperative risk assessment in patients undergoing elective, urgent, or emergent cardiac surgery." ]

pub

false