Thrombolysis Therapy Mortality - Intracranial Hemorrhage After AMI

Description

Sloan et al developed a model for predicting 30 day mortality in patients who develop intracranial hemorrhage after thrombolytic therapy for acute myocardial infarction (AMI). This can help identify patients who may benefit from more aggressive management and monitoring. The authors are investigators from the GUSTO-I trial.

Parameters:

(1) age

(2) Glasgow Coma Score

(3) time interval between thrombolysis and onset of stroke in hours

(4) volume of intracranial hemorrhage in mL

Age	Points
<= 40	0
45	2
50	4
55	5
60	7
65	9
70	11
75	13
80	14
85	16
>=90	18

When modeled in JMP, this can be represented as:

points =

= (0.3326 * (age)) - 12.985

GCS	Points
15	0
14	2
13	3
12	5
11	7
10	8
9	10
8	12
7	13
6	15
5	16
4	18
3	20

Hours after Thrombolysis	Points
0	100
20	93
40	87
60	80
80	73
100	67
120	60
140	53
160	47
180	40
200	33
220	27
240	20
260	13
280	7
>= 300	0

When modeled in JMP, this can be represented as:

points =

= (-0.333 * (hours)) + 99.963

Volume in mL	Points
0 – 50	0
60	2
80	5
100	9
120	13
140	16
160	20
180	24
200	27
220	31
240	35
260	38
280	42
300	46

When modeled in JMP, this can be represented as:

points =

= (0.1833 * (volume in mL)) - 9.2905

total score =

= SUM(points for all 4 parameters)

Interpretation:

• minimum score:0

• maximum score: 256

• The higher the score the greater the risk of 30 day mortality.

Total Score	30 Day Mortality Rate
0 – 86	< 1%
87	1%
97	5%
101	10%
109	30%
115	50%
120	70%
128	90%
132	95%
142	99%
143 – 256	> 99%

When modeled in JMP, this can be represented as:

Score	Mortality Rate in Percent
87 - 109	(0.001975 * ((score)^3)) - (0.5022 * ((score)^2)) + (42.602 * (score)) - 1204.894
109 - 120	(0.0606 * ((score)^2)) - (10.2324 * (score)) + 426.36
120 - 142	(0.001975 * ((score)^3)) - (0.8547 * ((score)^2)) + (123.328 * (score)) - 5834.571

Alternatively, analyzing the data in JMP:

X = (0.166 * (score)) - 19.06

probability =

= 1 / (1 + EXP((-1) * X))

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Description

Specialty

Objective

ICD-10

Model of Sloan et al for Risk of 30-Day Mortality Associated with Intracranial Hemorrhage Associated with Thrombolysis Therapy After Acute Myocardial Infarction

Purpose: To estimate 30-day mortality in a patient with intracranial hemorrhage after thrombolytic therapy for AMI using the model of Sloan et al.

Description

Specialty

Objective

ICD-10