Mrdovic et al reported a risk score for serious bleeding after percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). This can help to identify a patient who may more aggressive management after the procedure. The authors are from the University of Belgrade, Institute for Medical Statistics and Informatics, and the Clinical Center of Serbia.
Patient selection: PCI for STEMI
Outcome: serious bleeding within 30 days (hemoglobin drop >= 30 g/L; transfusion; hemorrhagic cardiac tamponade; bleeding requiring surgical intervention; incranial bleeding; shock requiring vasoactive drugs; intraocular bleeding with vision loss; death)
Parameters:
(1) sex
(2) history of peptic ulcer
(3) creatinine clearance in mL per minute
(4) hemoglobin in g/L
(5) Killip class
Parameter
Finding
Point
beta-coefficient
sex
male
0
0
female
1
0.62
peptic ulcer
no
0
0
yes
1
0.89
creatinine clearance
>= 60
0
0
< 60
2
1.16
hemoglobin
>= 125 g/L
0
0
< 125
2
1.02
Killip class
1
0
0
> 1
2
1.06
total score =
= SUM(points for all 5 parameters)
X =
= SUM(beta-coefficients for all 5 parameters) - 4.28
probability of serious bleeding =
= 1/(1+EXP((-1) * X))
Interpretation:
• minimum score: 0
• maximum score: 8
• The higher the score the greater the risk of serious bleeding.
• A score >=3 was considered high risk.
• A score of 0 was low risk.
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