Models of Tu et al for Mortality After an Acute Myocardial Infarction (Ontario Acute Myocardial Infarction Mortality Prediction Rule): 1-Year Mortality
Tu et al developed models for mortality after acute myocardial infarction (AMI). The models can help to identify a patient who may benefit from more aggressive management. The authors are from University of Toronto, University of Manitoba, and Stanford University.
Patient selection: acute myocardial infarction
Outcome: 1-year mortality
Parameters:
(1) age in years
(2) gender
(3) shock on admission
(4) diabetes with complications
(5) congestive heart failure (CHF)
(6) cancer
(7) cerebrovascular disease
(8) pulmonary edema
(9) acute renal failure
(10) chronic renal failure
(11) cardiac dysrhythmia
Parameters
Findings
Points
age
< 50 years
0
50 to 64 years
0.9412
65 to 74 years
1.7846
>= 75 years
2.6226
gender
male
0
female
0.1386
shock on admission
absent
0
present
2.754
diabetes with complications
absent
0
present
0.6571
CHF
absent
0
present
0.7659
cancer
absent
0
present
1.315
cerebrovascular disease
absent
0
present
0.7705
pulmonary edema
absent
0
present
0.6587
acute renal failure
absent
0
present
1.3564
chronic renal failure
absent
0
present
0.8529
cardiac dysrhythmia
absent
0
present
0.2776
X =
= SUM(points for all 11 parameters) - 3.5965
probability of 30-day mortality =
= 1 / (1 + EXP((-1) * X))
The 2 risk factors with highest probability for 1-year mortality are shock on admission (odds ratio 15.7) and age >= 75 years (odds ratio 13.8).
Performance:
• The area under the ROC curve was 0.79.
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