Risk Score of Kramer et al for Predicting Early Mortality of a Patient with an Implantable Cardioverter-Defibrillator (ICD)

Description

Kramer et al reported a score for predicting early mortality for a patient with an implantable cardioverter-defibrillator (ICD). This can help to identify a patient who may benefit from more aggressive management. The authors are from Beth Israel Deaconess Medical Center, Mayo Clinic and the Minneapolis Heart Institute.

Patient selection: implantable cardioverter-defibrillator (ICD)

Outcome: 1-year mortality

Parameters:

(1) peripheral arterial disease

(2) left ventricular ejection fraction (LVEF) in percent

(3) serum creatinine in mg/dL

(4) age of the patient in years

Parameter	Finding	Points
peripheral arterial disease	absent	0
	present	1
LVEF	> 20%	0
	<= 20%	1
serum creatinine	< 2.0 mg/dL	0
	>= 2.0 mg/dL	2
age in years	< 70 years	0
	>= 70 years	1

total score =

= SUM(points for all 4 parameters)

Interpretation:

• minimum score: 0

• maximum score: 5

• The higher the score the greater the risk of early mortality.

Total Score	1-Year Mortality
0	1.7%
1	4%
2	6.9%
3	15.5%
4 or 5	18.2%

Performance:

• The area under ROC curve is 0.80.

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Risk Score of Kramer et al for Predicting Early Mortality of a Patient with an Implantable Cardioverter-Defibrillator (ICD)

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