Hao et al reported a model for predicting myocardial injury in a patient with upper gastrointestinal tract bleeding. The presence of myocardial injury is associated with greater in-hospital mortality (11% vs 2%). The authors are from Xi'an Jiaotong University in China.
Patient selection: upper GI bleeding.
Myocardial injury was defined as one of the following: ST segment changes in 2 consecutive leads of the ECG; elevated troponin T (> 0.014 ng/mL); elevated troponin I (> 0.026 ng/mL)
Parameters:
(1) hypertension
(2) serum urea in mmol/L, from 0 to 40
(3) left ventricular ejection fraction (LVEF) in percent
points for serum urea =
= 2.5 * (urea)
Parameter
Finding
Points
hypertension
no
0
yes
30.3
LVEF
>= 68%
0
< 68%
25.2
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 155.5
value of X =
= (0.04467 * (score)) - 3.33
risk of myocardial ischemia =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.82.
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