Williams et al reported a prognostic score for a patient with acute myocardial infarction. This can help to identify a patient who may require more aggressive management. The authors are from the Mayo Clinic.
Patient selection: acute myocardial infarction
Parameters:
(1) age in years
(2) sex
(3) systolic blood pressure in mm Hg
(4) serum creatinine in mg/dL
(5) ST depression in microVolts
(6) QRS duration in milliseconds
(7) Killip class
(8) AMI location
Parameter |
Findings |
Points |
age |
<= 80 years |
0 |
|
> 80 years |
2 |
sex |
male |
0 |
|
female |
3 |
systolic blood pressure |
<= 140 mm Hg |
3 |
|
> 140 mm Hg |
0 |
serum creatinine |
<= 1.4 mg/dL |
0 |
|
> 1.4 mg/dL |
1 |
ST depression |
none or < 1 µV |
0 |
|
1 to 2 µV |
1 |
|
> 2 µV |
3 |
QRS duration |
< 100 milliseconds |
0 |
|
>= 100 milliseconds |
1 |
Killip class |
I |
0 |
|
II to IV |
3 |
AMI location |
anterior |
1 |
|
other |
0 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 17
• The higher the score the greater the 30-day mortality.
Score |
30-day Mortality |
0 to 5 |
< 5% (low) |
6 or 7 |
15% |
8 or 9 |
20% |
10 to 17 |
> 30% (high) |
Performance:
• The area under the ROC curve is 0.78.
Specialty: Cardiology