NOTE: Another risk model by Krumholz for elderly AMI patients (dealing with in-hospital mortality) is reported in 06.08.22.
Patient selection: adults >= 65 years of age with AMI
Outcome: 1 year mortality after the AMI
Parameters:
(1) peripheral vascular disease
(2) age of the patient in years
(3) body mass index (BMI)
(4) urinary incontinence or no urinary output
(5) walking ability with and without assistance
(6) left ventricular ejection fraction (LVEF) in percent
(7) heart failure or cardiomegaly diagnosed prior to discharge
(8) renal dysfunction (serum creatinine > 2.5 mg/dL or BUN > 40 mg/dL)
|
Parameter
|
Finding
|
Points
|
|
peripheral vascular disease
|
absent
|
0
|
|
|
present
|
1
|
|
age of the patient
|
65 to 74 years
|
0
|
|
|
75 to 84 years
|
1
|
|
|
>= 85 years
|
2
|
|
body mass index
|
< 20 kg per meter squared
|
1
|
|
|
>= 20 kg per meter squared
|
0
|
|
urinary incontinence or no urine output
|
no
|
0
|
|
|
yes
|
1
|
|
walking
|
does not require assistance
|
0
|
|
|
requires assistance
|
1
|
|
|
unable to walk
|
2
|
|
LVEF
|
< 20%
|
3
|
|
|
20 to 40%
|
2
|
|
|
> 40%
|
0
|
|
heart failure or cardiomegaly
|
no
|
0
|
|
|
yes
|
2
|
|
renal dysfunction
|
no
|
0
|
|
|
yes
|
2
|
where:
• One item describes urinary incontinence or no urinary output. Another mentions renal dysfunction. The absence of urinary output might imply renal dysfunction.
risk score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 14 (maximum observed in study 13)
• The higher the score the greater the risk of 1 year mortality.
|
Total Score
|
1 Year Mortality Rate
|
|
0 to 2
|
low risk
|
|
3 to 5
|
moderate risk
|
|
>= 6
|
high risk
|
