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.
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