De Luca et al developed a prognostic score for evaluating a patient undergoing primary angioplasty after an ST-segment elevation myocardial infarction (STEMI). This can help identify a patient at increased risk for mortality within 30 days of the procedure. The authors are from Hospital De Weezenlanden in Zwolle, the Netherlands.
Outcome: death within 30 days
Parameters:
(1) Killip Class
(2) TIMI flow
(3) age of the patient in years
(4) number of vessels involved
(5) anterior infarction
(6) ischemic time in hours
Parameter |
Finding |
Point |
---|---|---|
Killip class |
1 |
0 |
|
2 |
4 |
|
3 or 4 |
9 |
TIMI flow |
3 |
0 |
|
2 |
1 |
|
0 or 1 |
2 |
age of the patient |
< 60 years |
0 |
|
>= 60 years |
2 |
number of vessels involved |
1 or 2 |
0 |
|
3 |
1 |
anterior infarct |
no |
0 |
|
yes |
1 |
ischemic time |
<= 4 hours |
0 |
|
> 4 hours |
1 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 16
• The higher the score the greater the risk of death by 30 days.
Total Score |
Percent Mortality |
0 or 1 |
0 |
2 |
0.5 - 0.9% |
3 |
1.1 - 1.3% |
4 |
1.4 - 2.8% |
5 |
3.9 - 6.7% |
6 |
5 - 7.3% |
7 |
9.1 - 10.7% |
8 |
11.8 - 14.3% |
9 |
23.1 - 25% |
> 10 |
35.3 - 44.1% |
Purpose: To evaluate a patient undergoing a primary angioplasty following an ST-segment elevation myocardial infarction (STEMI) using the Zwolle score.
Specialty: Cardiology
Objective: severity, prognosis, stage
ICD-10: I20, I21, I25, Y84.0,