Basic Metabolic Profile (BMP)
Relevant Social Security Medical Listings
- Listing 4.04 Ischemic Heart Disease (Adults)
Other Names
Basic Metabolic Profile (BMP) Risk Score
Type
Objective/Test Score (Cardiovascular)
Can SSA Purchase?
Yes, but it is unlikely. However, test results should always be considered as part of the evidence of record when provided by a treating doctor.
Purpose
Assess risk for death from cardiovascular disease.
Technique
A variety of routine blood test results, as well as gender and age, are combined to obtain an overall cardiovascular risk score that is more predictive than any single test. The blood tests are for sodium, potassium, calcium, glucose, bicarbonate, and creatinine. Each blood test result is assigned a numerical score of 0-5, depending on what range of values the patient’s test result falls into. For an age of at least 80 years, values as high as 9 can be assigned.
| BMP RISK SCORE VALUES | ||||
| Variable | 30-day Death | 1-year Death | 5-year Death | |
| Sodium (mmol/L) | ||||
| Low | <135 | 2 | 2 | 3 |
| Normal | 135-146 | 0 | 0 | 0 |
| High | >146 | 5 | 4 | 3 |
| Potassium (mmol/L) | ||||
| Low | <3.5 | 1 | 1 | 1 |
| Normal | 3.5-5.3 | 0 | 0 | 0 |
| High | >5.3 | 2 | 2 | 2 |
| Bicarbonate (mmol/L) | ||||
| Low | <20 | 4 | 2 | 1 |
| Normal | 20-32 | 0 | 0 | 0 |
| High | >32 | 3 | 3 | 4 |
| Calcium (mmol/L) | ||||
| Low | <8.5 | 4 | 2 | 3 |
| Normal | 8.5-10.3 | 0 | 0 | 0 |
| High | >10.3 | 1 | 1 | 0 |
| Glucose (mg/dL) | ||||
| Low | <100 | 0 | 0 | 0 |
| Intermed. | 100-125 | 1 | 1 | 1 |
| High | >125 | 3 | 2 | 2 |
| Creatinine (mg/dL) | ||||
| Low | <0.8 | 1 | 1 | 1 |
| Normal | 0.8-1.19 | 0 | 0 | 0 |
| High | 1.2-1.99 | 2 | 1 | 1 |
| Very High | ≥2 | 4 | 4 | 4 |
| Age (years) | ||||
| 18-29 | -2 | -3 | -3 | |
| 30-39 | -1 | -3 | -3 | |
| 40-49 | 0 | 0 | 0 | |
| 50-59 | 0 | 1 | 1 | |
| 60-69 | 2 | 2 | 2 | |
| 70-79 | 3 | 4 | 4 | |
| ≥80 | 5 | 7 | 9 | |
| Sex | ||||
| Female | 0 | 0 | 0 | |
| Male | 0 | 1 | 1 | |
| Adapted from Am. Heart J 2009; 157:946-54 | ||||
Interpretation
Based on the study of several hundred thousand patients, the percentages expected to die at the specified intervals of 30 days, 1 year, and 5 years based on the given risk scores is given in the following table. This information can be used to make treatment decisions in individual patients and the appropriate test values for population screening.
Certain thresholds for BMP score are most useful in making predictions. For BMP scores of 5 or greater, the sensitivity and specificity for predicting 30-day death are 89.9% and 70.3%, respectively; for a BMP of 4 or greater, there is a sensitivity of 88.8% and specificity of 62.5% for predicting 1-year death; and for a BMP of 4 or greater, there is an 87.9% sensitivity and 64.7% specificity in predicting death at 5 years.
| PERCENT OF POPULATION FOR EACH BMP RISK SCORE | |||
| Risk Score | 30-day Death | 1-year Death | 5-year Death |
| -3 | – | 3.6% | 2.1% |
| -2 | 6.1% | 6.0% | 3.5% |
| -1 | 9.0% | 5.6% | 3.3% |
| 0 | 14.4% | 8.4% | 5.2% |
| 1 | 9.0% | 10.2% | 6.3% |
| 2 | 8.8% | 11.5% | 7.6% |
| 3 | 10.6% | 10.1% | 6.9% |
| 4 | 7.3% | 9.5% | 7.5% |
| 5 | 8.3% | 7.8% | 7.3% |
| 6 | 5.9% | 6.0% | 6.2% |
| 7 | 5.1% | 5.3% | 5.1% |
| 8 | 4.3% | 4.4% | 3.9% |
| 9 | 2.8% | 3.8% | 4.7% |
| 10 | 2.7% | 2.7% | 5.7% |
| 11 | 1.7% | 1.9% | 5.9% |
| 12 | 1.5% | 1.3% | 4.3% |
| 13 | 0.8% | 0.8% | 3.7% |
| 14 | 0.8% | 0.5% | 3.0% |
| 15 | 0.3% | 0.3% | 2.5% |
| 16 | 0.3% | 0.2% | 1.7% |
| 17 | 0.1% | 0.1% | 1.3% |
| 18 | 0.1% | 0.1% | 0.7% |
| 19 | <0.1% | <0.1% | 0.7% |
| 20 | <0.1% | <0.1% | 0.3% |
| 21 | <0.1% | <0.1% | 0.1% |
| 22 | <0.1% | <0.1% | 0.1% |
| 23 | <0.1% | <0.1% | <0.1% |
| 24 | <0.1% | – | <0.1% |
| 25 | <0.1% | – | <0.1% |
| 26 | <0.1% | – | – |
| Adapted from Am. Heart J 2009; 157:946-54 | |||
