acef_ii_cardiac_surgery: ACEF II Risk Score for Cardiac Surgery

In cliot: Clinical Indices and Outcomes Tools

ACEF II Risk Score for Cardiac Surgery

Description

Calculates the ACEF II (Age, Creatinine, Ejection Fraction II) Risk Score to predict 30-day operative mortality in patients undergoing elective or emergency cardiac surgery. This updated version of the original ACEF score incorporates emergency status and preoperative anemia (hematocrit).

Usage

acef_ii_cardiac_surgery(age, ejection_fraction, creatinine_mg_dl,
                        hematocrit, emergency_surgery)

Arguments

age	Numeric. Patient age in years.
ejection_fraction	Numeric. Left ventricular ejection fraction in percentage (e.g., 50 for 50%).
creatinine_mg_dl	Numeric. Serum creatinine level in mg/dL. (Score adds 2.0 points if > 2.0 mg/dL).
hematocrit	Numeric. Preoperative hematocrit in percentage (e.g., 38 for 38%). (Score adds 0.2 points for each percentage point below 36%).
emergency_surgery	Numeric (0 or 1). 1 if surgery is emergency (required before the beginning of the next working day), 0 otherwise. (Score adds 3.0 points if Yes).

Value

A list containing:

ACEF_II_Score	The calculated risk score.
Interpretation	General prognostic guidance.

References

Ranucci M, Castelvecchio S, Menicanti L, et al. The ACEF II Risk Score for cardiac surgery: updated but still parsimonious. Eur Heart J. 2018;39(23):2183-2189. doi:10.1093/eurheartj/ehx039

Examples

# Example 1: Low Risk
# 65yo, EF 55%, Cr 1.0, Hct 40%, Elective
# Score = 65/55 = 1.18
acef_ii_cardiac_surgery(65, 55, 1.0, 40, 0)

# Example 2: High Risk
# 75yo, EF 30%, Cr 2.5, Hct 30%, Emergency
# Score = (75/30) + 2.0 + 3.0 + (0.2 * (36-30))
#       = 2.5 + 2.0 + 3.0 + 1.2 = 8.7
acef_ii_cardiac_surgery(75, 30, 2.5, 30, 1)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.