The Coronary Prognostic Index (CPI) uses 6 accessible clinical parameters to give the mortality risk for patients with myocardial infarction. The data is from 1969 and so the mortality risk assessment must be tempered by changes in patient management.
Parameters:
(1) age in years
(2) cardiac location of infarct
(3) admission systolic blood pressure in mm Hg
(4) heart size
(5) lung fields
(6) history of previous angina or infarction
coronary prognostic index =
= ((weighting for age) * (number for age)) + ((weighting for infarct location) * (number for infarct location)) + ((weighting for systolic blood pressure) * (number for systolic blood pressure)) + ((weighting for heart size) * (number for heart size)) + ((weighting for lung fields) * (number for lung fields)) + ((weighting for history of previous ischemia) * (number for history of previous ischemia))
|
parameter |
number |
|---|---|
|
age in years |
3.9 |
|
position of infarct |
2.8 |
|
admission systolic blood pressure |
10.0 |
|
heart size |
1.5 |
|
lung fields |
3.3 |
|
history of previous ischemia |
0.4 |
|
age in years |
weighting |
|---|---|
|
< 50 |
0.2 |
|
50-59 |
0.4 |
|
60-69 |
0.6 |
|
70-79 |
0.8 |
|
80-89 |
1.0 |
|
position of infarct |
weighting |
|---|---|
|
anterior transmural |
1.0 |
|
left bundle branch block |
1.0 |
|
posterior transmural |
0.7 |
|
anterior subendocardial |
0.3 |
|
posterior subendocardial |
0.3 |
|
admission systolic blood pressure |
weighting |
|---|---|
|
< 55 mm Hg |
1.0 |
|
55-64 mm Hg |
0.7 |
|
65-74 mm Hg |
0.6 |
|
75-84 mm Hg |
0.5 |
|
85-94 mm Hg |
0.4 |
|
95-104 mm Hg |
0.3 |
|
105-114 mm Hg |
0.2 |
|
115-124 mm Hg |
0.1 |
|
>= 125 mm Hg |
0 |
|
heart size |
weighting |
|---|---|
|
normal |
0 |
|
doubtfully enlarged |
0.5 |
|
definitely enlarged |
1.0 |
|
lung fields |
weighting |
|---|---|
|
normal |
0 |
|
venous congestion |
0.3 |
|
interstitial edema |
0.6 |
|
pulmonary edema |
1.0 |
|
history of previous ischemia |
weighting |
|---|---|
|
no history of previous ischemia |
0 |
|
history of previous ischemia or infarct |
1 |
Interpretation
• minimum score: 1.62
• maximum score: 21.9
|
CPI |
mortality rate |
|---|---|
|
< 4 |
3% |
|
4-5 |
9% |
|
6-7 |
22% |
|
8-9 |
40% |
|
10-11 |
63% |
|
>= 12 |
78% |
Limitations:
• The mortality risk is that seen in 1969 and would not be seen today with newer modalities of treatment. However, the mortality risk would probably be accurate for those patients left untreated or receiving only supportive care.
• It is possible that the mortality risk with higher scores (above 16-18) would be higher than the given 78%
Specialty: Cardiology
ICD-10: ,
