Hannan et al reported the New York State PCI Risk score patients undergoing percutaneous coronary intervention (PCI). This can identify a patient at risk for in-hospital or 30 day mortality. The authors are from multiple institutions in the United States.
Patient selection: status post PCI
Parameters:
(1) age in years
(2) sex
(3) hemodynamic state
(4) left ventricular ejection fraction in percent
(5) pre-procedural AMI and ECG findings
(6) peripheral vascular disease
(7) current or past congestive heart failure (CHF)
(8) malignant ventricular arrhythmia
(9) COPD
(10) renal failure
(11) 2 or 3 vessels diseased
(12) left main coronary artery disease
|
Parameter |
Finding |
Points |
|
age |
< 66 years |
0 |
|
|
66 to 75 years |
1 |
|
|
76 to 85 years |
3 |
|
|
>= 86 years |
5 |
|
sex |
male |
0 |
|
|
female |
1 |
|
hemodynamic state |
stable |
0 |
|
|
unstable |
4 |
|
|
shock |
9 |
|
LVEF |
>= 50% |
0 |
|
|
30 to 49% |
1 |
|
|
20 to 29% |
2 |
|
|
< 20% |
4 |
|
AMI and ECG |
ST segment elevation and < 6 hours |
7 |
|
|
ST segment elevation and 6-11 hours |
6 |
|
|
ST segment elevation and 12-23 hrs |
8 |
|
|
NSTEMI and < 6 hours |
4 |
|
|
NSTEMI and 6 to 11 hours |
5 |
|
|
NSTEMI and 12-23 hours |
4 |
|
|
STEMI or NSTEMI and 1-14 days |
3 |
|
|
STEMI or NSTEMI and > 14 days |
0 |
|
peripheral vascular disease |
no |
0 |
|
|
yes |
1 |
|
CHF |
no |
0 |
|
|
yes |
2 |
|
malignant ventricular arrhythmia |
no |
0 |
|
|
yes |
4 |
|
COPD |
no |
0 |
|
|
yes |
2 |
|
renal failure |
no |
0 |
|
|
creatinine 1.6 to 2.0 mg/dL |
2 |
|
|
creatinine >= 2.1 mg/dL |
3 |
|
|
requires dialysis |
5 |
|
2 or 3 vessel disease |
no |
0 |
|
|
yes |
1 |
|
left main disease |
no |
0 |
|
|
yes |
1 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 43
• The higher the score the greater the risk of in-hospital or 30-day mortality.
|
Score |
Outcome |
|
0 |
0.09% |
|
1 |
0.13% |
|
2 |
0.18% |
|
3 |
0.25% |
|
4 |
0.35% |
|
5 |
0.48% |
|
6 |
0.67% |
|
7 |
0.94% |
|
8 |
1.3% |
|
9 |
1.8% |
|
10 |
2.5% |
|
11 |
3.5% |
|
12 |
4.8% |
|
13 |
6.6% |
|
14 |
8.9% |
|
15 |
12% |
|
16 |
16% |
|
17 |
21% |
|
18 |
27% |
|
19 |
34% |
|
20 |
42% |
|
21 |
50% |
|
22 |
59% |
|
23 |
66% |
|
24 |
73% |
|
25 |
79% |
|
26 |
84% |
|
27 |
88% |
|
28 |
91% |
|
29 |
94% |
|
30 |
95% |
|
31 |
97% |
|
32 to 34 |
98% |
|
35 to 43 |
> 99% |
Specialty: Cardiology
