Models of Tu et al for Mortality After an Acute Myocardial Infarction (Ontario Acute Myocardial Infarction Mortality Prediction Rule): 30-Day 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: 30-day 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
0.8811
65 to 74 years
1.7217
>= 75 years
2.5045
gender
male
0
female
0.1607
shock on admission
absent
0
present
3.105
diabetes with complications
absent
0
present
0.3467
CHF
absent
0
present
0.3231
cancer
absent
0
present
0.7279
cerebrovascular disease
absent
0
present
0.6776
pulmonary edema
absent
0
present
0.4272
acute renal failure
absent
0
present
1.3005
chronic renal failure
absent
0
present
0.3826
cardiac dysrhythmia
absent
0
present
0.2858
X =
= SUM(points for all 11 parameters) - 4.0128
probability of 30-day mortality =
= 1 / (1 + EXP((-1) * X))
The 2 risk factors with highest probability for 30-day mortality are shock on admission (odds ratio 22.3) and age >= 75 years (odds ratio 12.2).
Performance:
• The area under the ROC curve was 0.78.
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