Model of Cheng et al for Predicting 30-Day Mortality for a Patient with ST-Elevation Myocardial Infarction (STEMI) and Cardiogenic Shock Undergoing Percutaneous Coronary Intervention (PCI)

Description

Cheng et al developed risk table for patients with ST-elevation myocardial infarction (STEMI) and cardiogenic shock. This can help to identify a patient who may benefit from more aggressive management. The authors are from Erasmus Medical Center in Rotterdam.

Patient selection: STEMI with cardiogenic shock undergoing PCI

Outcome: 30-day mortality

Parameters available at time of admission:

(1) serum creatinine relative to upper limit of normal for gender

(2) serum lactate in mmol/L

(3) age in years

Upper limit of serum creatinine for males: 115 µmol/L

Upper limit of serum creatinine for females: 90 µmol/L

Creatinine	Lactate	Age	percent
<= ULN	< 1.7	< 55 years	8
		55 to 64	12
		65 to 75	19
		> 75 years	26
	1.7 to 5.0	< 55 years	14
		55 to 64	21
		65 to 75	31
		> 75 years	43
	5.1 to 8.5	< 55 years	24
		55 to 64	34
		65 to 75	46
		> 75 years	49
	> 8.5	< 55 years	37
		55 to 64	50
		65 to 75	62
		> 75 years	73
> ULN	< 1.7	< 55 years	19
		55 to 64	29
		65 to 75	40
		> 75 years	53
	1.7 to 5.0	< 55 years	32
		55 to 64	44
		65 to 75	56
		> 75 years	68
	5.1 to 8.5	< 55 years	47
		55 to 64	60
		65 to 75	71
		> 75 years	81
	> 8.5	< 55 years	63
		55 to 64	74
		65 to 75	83
		> 75 years	89

where:

• The breakpoints have issues. There was no coverage for creatinine equal to ULN. Lactate overlaps at 5.1. Ages overlap at 65.

Performance:

• The area under the ROC curve was 0.75.

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Description

Specialty

ICD-10