Singh et al developed a risk score for predicting complications following a percutaneous coronary intervention (PCI). The score can help identify those patients who are more likely to have a complication and who may benefit from more aggressive management. The authors are from the Mayo Clinic.
Complications considered:
(1) death in-hospital
(2) Q wave acute myocardial infarction
(3) urgent or emergent coronary artery bypass graft (CABG)
(4) cerebrovascular accident during the index admission
Parameters:
(1) age in decades after age 30
(2) cardiogenic shock
(3) left main coronary artery disease
(4) multi-vessel coronary artery disease
(5) serum creatinine
(6) timing for the procedure
(7) thrombus
(8) NYHA class
|
Parameter |
Finding |
Points |
|---|---|---|
|
age in decades after 30 years |
< 40 |
0 |
|
|
40 to 49 |
1 |
|
|
50 to 59 |
2 |
|
|
60 to 69 |
3 |
|
|
70 to 79 |
4 |
|
|
80 to 89 |
5 |
|
|
90 to 99 |
6 |
|
|
100 to 109 |
7 |
|
cardiogenic shock |
absent |
0 |
|
|
present |
5 |
|
left main coronary artery disease |
absent |
0 |
|
|
present |
5 |
|
multi-vessel disease |
absent |
0 |
|
|
present |
2 |
|
serum creatinine |
<= 265 µmol/L |
0 |
|
|
> 265 µmol/L |
3 |
|
timing for procedure |
elective |
0 |
|
|
urgent or emergent |
2 |
|
thrombus |
absent |
0 |
|
|
present |
2 |
|
NYHA class |
I or II |
0 |
|
|
III or IV (heart failure present) |
2 |
where:
• The points for age is from de Feyter and McFadden.
• The model coefficients are given in Table 1, page 1723.
• Vessel disease is >= 70% occlusion on angiography.
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 27+ (depends on age)
• The higher the score the greater the risk for complications.
|
Total Score |
Risk Group |
Percent Complications |
|
0 to 5 |
very low |
1% |
|
6 to 8 |
low |
2% |
|
9 to 11 |
moderate |
7% |
|
12 to 14 |
high |
9% |
|
>= 15 |
very high |
40% |
where:
• A 9% complication rate (while serious) is not high except in a relative sense.
Purpose: To evaluate a patient undergoing a percutaneous coronary intervention (PCI) for risk of complications as reported by Singh et al (Mayo Clinic risk score).
Specialty: Cardiology
Objective: risk factors, severity, prognosis, stage, complications
ICD-10: I20, I21, I25, Y84.0,
