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The Eagle score, along with Detsky and Goldman tests, is used to determine mortality risks in cardiovascular patients prior to surgery. The score is based on five categories, with higher scores indicating higher risk. Healthcare professionals also use the dipyridamole/thallium scan to provide a visual study of the heart and blood vessels.
The Eagle score is one of the tests commonly used by diagnosticians to determine mortality risks in cardiovascular patients prior to surgery. Physicians use the five-point medical scoring system combined with Detsky and Goldman tests, which factor in categories that include a patient’s age, cardiac status, lab values, and other medical conditions. Assessments provide an assessment of the patient’s level of risk. Healthcare professionals also use the dipyridamole/thallium scan to provide a visual study of the heart and blood vessels.
There are five categories used to determine an Eagle score. The first three indicate whether the patient is over 70, suffers from angina and has diabetes. The fourth is whether the patient shows a certain type of Q wave on an EKG; this may indicate dead muscle tissue, a sign of a previous heart attack. A diagnosis of ventricular arrhythmia, a type of heart rhythm disorder, is the fifth category. Some Eagle Score assessments also ask if the patient has congestive heart failure or a history of myocardial infarction, also called a stroke.
The suspected fatality rate for patients who do not fit into either category is usually 3%. The rate rises to 8% in patients who fit one or two categories and rises dramatically to 18% for those who fit into three categories. The Eagle score rating is typically shown alongside the Detsky and Goldman scores, which are other measures of cardiac risk with slightly different categories, in different columns on the same form.
A written survey assigns specific numbers, in the Detsky and Goldman columns, for each of the risk categories considered by each index. A Detsky score above 15, combined with a Goldman score above 12, which falls into more than three categories on the Eagle score, typically indicates that a patient is a high-risk surgical candidate. Low scores on the Detsky and Goldman tests and no Eagle scores generally indicate a patient at lower surgical risk.
Six different categories are typically considered when examining a patient’s cardiac risk, combining the questions of the Eagle score with the Detsky and Goldman portions of the test. The former includes patient history, patient age, history of myocardial infarction, and the possibility of pulmonary edema, which is the accumulation of fluid in the lungs. An angina category assesses whether the condition is stable.
The cardiac exam determines whether patients have congestive heart failure or aortic stenosis, a condition in which the valve that controls blood flow from the heart doesn’t open fully. The electrocardiogram category indicates the presence of specific arrhythmias. A category of general medical conditions is based on laboratory values that include blood gases, blood urea nitrogen (BUN), creatinine levels, and underlying medical diagnosis. The last category indicates the type of surgery required by the patient.
Doctors generally not only rely on the written survey, but also do a dipyridamole-thallium study. This scanning procedure evaluates the cardiovascular system while the system is under chemical stress. Doctors administer a vasoconstrictor, dipyridamole, to narrow blood vessels, along with a radioactive substance, thallium, to monitor the condition of blood vessels and the heart. This test refutes or further verifies the results obtained from the Eagle score-Detsky-Goldman written assessment survey.
