Klein et al developed a model for predicting mortality in a patient undergoing percutaneous coronary intervention (PCI) for an acute myocardial infarction complicated by cardiogenic shock. The authors are from multiple universities in the United States participating in the American College of Cardiology National Cardiovascular Data Registry.
Criteria for cardiogenic shock:
(1) clinical state of hypoperfusion
(2) systolic blood pressure < 80 mm Hg
(3) pulmonary artery wedge pressure > 20 mm Hg
(4) cardiac index < 1.8 liters per minute per square meter
(5) need for intravenous inotrope therapy and/or an intra-aortic balloon pump to maintain the systolic blood pressure > 80 mm Hg and cardiac index > 1.8 L per min per square meter
Outcome: in-hospital mortality
Parameters:
(1) age
(2) renal failure
(3) total occlusion of the proximal left anterior descending (LAD) coronary artery
(4) gender
|
Parameter |
Finding |
Points |
|
age of the patient in years |
< 50 years of age |
0 |
|
|
50 to 59 years of age |
25 |
|
|
60 to 69 years of age |
50 |
|
|
70 to 79 years of age |
75 |
|
|
>= 80 years of age |
100 |
|
renal failure |
absent |
0 |
|
|
present |
88 |
|
total occlusion LAD |
no |
0 |
|
|
yes |
50 |
|
gender |
male |
0 |
|
|
female |
24 |
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 262
• The higher the score the greater the risk for mortality.
|
Total Score |
Probability of Death |
|
< 8 |
< 30% |
|
8 to 243 |
(-0.000813 * ((points)^2)) + (0.4917 * (points)) + 24.3 |
|
>= 244 |
> 95% |
Specialty: Cardiology
ICD-10: ,
