A new simplified immediate prognostic risk score for patients with acute myocardial infarction

B. A. Williams, R. Scott Wright, J. G. Murphy, E. S. Brilakis, G. S. Reeder, A. S. Jaffe

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Immediate risk stratification of patients with myocardial infarction in the emergency department (ED) at the time of initial presentation is important for their optimal emergency treatment. Current risk scores for predicting mortality following acute myocardial infarction (AMI) are potentially flawed, having been derived from clinical trials with highly selective patient enrolment and requiring data not readily available in the ED. These scores may not accurately represent the spectrum of patients in clinical practice and may lead to inappropriate decision making. Methods: This study cohort included 1212 consecutive patients with AMI who were admitted to the Mayo Clinic coronary care unit between 1988 and 2000. A risk score model was developed for predicting 30 day mortality using parameters available at initial hospital presentation in the ED. The model was developed on patients from the first era (training set - before 1997) and validated on patients in the second era (validation set - during or after 1997). Results: The risk score included age, sex, systolic blood pressure, admission serum creatinine, extent of ST segment depression, QRS duration, Killip class, and infarct location. The predictive ability of the model in the validation set was strong (c = 0.78). Conclusion: The Mayo risk score for 30 day mortality showed excellent predictive capacity in a population based cohort of patients with a wide range of risk profiles. The present results suggest that even amidst changing patient profiles, treatment, and disease definitions, the Mayo model is useful for 30 day risk assessment following AMI.

Original languageEnglish (US)
Pages (from-to)186-192
Number of pages7
JournalEmergency Medicine Journal
Volume23
Issue number3
DOIs
StatePublished - Mar 2006

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Myocardial Infarction
Hospital Emergency Service
Mortality
Blood Pressure
Coronary Care Units
Aptitude
Emergency Treatment
Creatinine
Decision Making
Cohort Studies
Clinical Trials
Serum
Population

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Surgery
  • Nursing(all)
  • Emergency Medicine

Cite this

A new simplified immediate prognostic risk score for patients with acute myocardial infarction. / Williams, B. A.; Wright, R. Scott; Murphy, J. G.; Brilakis, E. S.; Reeder, G. S.; Jaffe, A. S.

In: Emergency Medicine Journal, Vol. 23, No. 3, 03.2006, p. 186-192.

Research output: Contribution to journalArticle

Williams, B. A. ; Wright, R. Scott ; Murphy, J. G. ; Brilakis, E. S. ; Reeder, G. S. ; Jaffe, A. S. / A new simplified immediate prognostic risk score for patients with acute myocardial infarction. In: Emergency Medicine Journal. 2006 ; Vol. 23, No. 3. pp. 186-192.
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