ACEF II Risk Score (Cardiac Surgery)

The ACEF II Risk Score estimates operative mortality in cardiac surgery using age, ejection fraction, creatinine, anemia, and urgency of surgery 1.

Creatinine (last recorded value before surgery)
Less than or equal to 2.0 mg/dL (177 µmol/L)0Greater than 2.0 mg/dL (177 µmol/L)+2
Emergency surgery (operation required before the beginning of the next working day after decision to operate)
No0Yes+3
Hematocrit (last recorded value before surgery)
If hematocrit greater than or equal to 36%035%+0.234%+0.433%+0.632%+0.831%+130%+1.229%+1.428%+1.627%+1.826%+225%+2.224%+2.423%+2.622%+2.821%+3
yrs
%

Indicaciones de Uso

Used for adult patients undergoing cardiac surgery (elective or emergency) to estimate operative (in‑hospital/30‑day) mortality and aid surgical risk stratification. Incorporates age/EF plus creatinine >2 mg/dL, emergency status, and anemia; validated in >7,000‑patient development and 1,687‑patient external cohorts with c‑statistic 0.814 1 [Level II evidence]. Outperforms original ACEF and approximates EuroSCORE II performance; especially practical when a simple, parsimonious model is preferred.

Información y Precauciones

Includes age/EF ratio plus penalties for creatinine >2 mg/dL, emergency surgery, and pre‑op anemia, improving discrimination vs the original (c‑statistic 0.814, superiority p=0.041) 1 [Level I evidence].

  • Best for rapid bedside estimation when full EuroSCORE II is impractical.
  • Cautions: underperforms EuroSCORE II in large real‑world cohorts (AUC 0.73 vs 0.792) 2 [Level II evidence]; limited accuracy in complex non‑CABG procedures; single‑center derivation.