The risk of mortality 1 year after an acute myocardial infarction with or without treatment with a thrombolytic agent can be estimated using a predictive instrument developed by Selker et al..
Parameters:
(1) age in years
(2) heart rate
(3) ST wave changes of anterior myocardial infarction
(4) abnormal Q waves
(5) right bundle branch block
|
Parameter |
Finding |
Value |
|
patient age |
< 60 years |
60 |
|
|
60 to < 75 years |
75 |
|
|
>= 75 years |
age |
|
heart rate |
< 70 beats per minute |
0 |
|
|
70 to < 120 beats per minute |
(heart rate) - 70 |
|
|
>= 120 beats per minute |
50 |
|
anterior myocardial infarction |
2 - 4 contiguous leads in V1, V2, V3, V4 with ST wave elevations |
1 |
|
|
0 or 1 contiguous leads in V1, V2, V3, V4 with ST wave elevations |
0 |
|
number of contiguous Q waves |
0 or 1 contiguous leads with abnormal Q waves |
0 |
|
|
2 - 4 contiguous leads with abnormal Q waves |
(number of contiguous leads with abnormal Q waves) - 1 |
|
|
> 4 contiguous leads with abnormal Q waves |
3 |
|
right bundle branch block |
present |
1 |
|
|
absent |
0 |
where:
• While the age given above is as listed in the paper, other age-related tables in the paper would have used the patient's age for 60 to < 75 and 75 if the age was >= 75.
• In contiguous leads with ST-wave elevations there must be at least 1 lead with an elevation >= 1 mm and 1 lead with an elevation >= 0.5 mm
• If more than 4 contiguous leads have abnormal Q waves, the number of contiguous leads is set to 4. This is equivalent to MIN(4, leads with Q waves).
score =
= (0.1085 * (value for age)) + (0.0371 * (value for heart rate)) + (0.1464 * (value for number of leads with contiguous Q waves)) + (0.5855 * (value for anterior acute MI)) + (1.2458 * (value for right bundle branch block)) - 11.1084
risk of mortality after 30 days =
= 1 / (1 + EXP((-1) * (score)))
risk of 1 year mortality =
= (risk of 30 day mortality) + ((1 - (risk of 30 day mortality)) * (risk of mortality after 30 days))
where:
• The risk of 30 day mortality may be with or without thrombolytic agent therapy.
Specialty: Cardiology
ICD-10: ,
