The coronary prognostic index of Peel et al uses clinical patient data to assess the severity of myocardial infarction. This can be used to predict the likely mortality rate for a patient and to compare treatment modalities. The design intention was to use the minimum of factors needed to give a reasonable prediction of mortality.
|
Parameter |
Finding |
Severity Score |
|
age and sex |
male < 55 years old |
0 |
|
|
male 55-59 years old |
1 |
|
|
male 60-64 years |
2 |
|
|
male >= 65 years |
3 |
|
|
female < 65 years old |
2 |
|
|
female >= 65 years old |
3 |
|
past history |
previous myocardial infarction |
6 |
|
|
exertional dyspnea (or) significant cardiovascular disease |
3 |
|
|
angina only |
1 |
|
|
no history of cardiovascular disease |
0 |
|
shock |
absent |
0 |
|
|
transient at onset (mild) |
1 |
|
|
present on admission but subsiding with rest and sedation (moderate) |
5 |
|
|
persisting despite rest and sedation |
7 |
|
heart failure |
absent |
0 |
|
|
only a few basal rales in lung fields |
1 |
|
|
breathlessness (or) acute pulmonary edema (or) orthopnea (or) dyspnea (or) gallop rhythm (or) liver enlargement (or) edema (or) jugular vein distension |
4 |
|
electrocardiogram |
normal |
0 |
|
|
normal QRS with abnormalities in RT segment and/or T waves |
1 |
|
|
QR complexes |
3 |
|
|
QS complexes (or) bundle branch block |
4 |
|
|
no ECG available |
4 |
|
rhythm |
sinus |
0 |
|
|
atrial fibrillation (or) atrial flutter (or) PAT (or) sinus tachycardia > 110 beats per minute (or) frequent ectopics (or) nodal rhythm (or) block |
4 |
modified prognostic index =
= (score for age and gender) + (score for past history) + (score for shock) + (score for heart failure) + (score for ECG) + (score for rhythm)
Interpretation:
• minimum score: 0
• maximum score: 28
|
Score |
Mortality |
|
1 – 2 |
0% |
|
3 – 8 |
2.7% |
|
9 – 10 |
11.4% |
|
11 – 12 |
13.2% |
|
13 – 14 |
22.8% |
|
15 – 16 |
24.2% |
|
17 – 20 |
53.4% |
|
21 – 23 |
84% |
|
24 - 28 |
100% |
Specialty: Cardiology
ICD-10: ,
