Chowdhary et al reported the Toronto score for predicting in-hospital morality following a percutaneous coronary intervention (PCI). This can help to identify a patient who may benefit from more aggressive management. The authors are from University Health Network in Toronto, Canada.
Patient selection: percutaneous coronary intervention (PCI)
Outcome: in-hospital mortality
Parameters:
(1) age in years
(2) diabetes mellitus
(3) renal insufficiency
(4) NYHA class
(5) left ventricular ejection fraction in percent (LVEF)
(6) multivessel coronary artery disease
(7) left main coronary artery disease
(8) recent myocardial infarction (within past month)
(9) postthrombolysis (rescue or facilitated PCI)
(10) primary PCI
(11) shock
|
Parameter |
Finding |
Points |
|
age in years |
< 40 |
0 |
|
|
40 to 49 |
1 |
|
|
50 to 59 |
2 |
|
|
60 to 69 |
3 |
|
|
70 to 79 |
4 |
|
|
>= 80 |
5 |
|
diabetes mellitus |
absent |
0 |
|
|
present |
2 |
|
renal insufficiency |
absent |
0 |
|
|
present |
2 |
|
NYHA class |
I, II, III |
0 |
|
|
IV |
3 |
|
LVEF |
>= 20% |
0 |
|
|
< 20% |
3 |
|
multivessel CAD |
absent |
0 |
|
|
present |
1 |
|
left main CAD |
absent |
0 |
|
|
present |
2 |
|
recent MI |
no |
0 |
|
|
yes |
3 |
|
postthrombolysis |
no |
0 |
|
|
yes |
3 |
|
primary PCI |
no |
0 |
|
|
yes |
4 |
|
shock |
absent |
0 |
|
|
present |
6 |
total score =
= SUM(points for all 11 parameters)
Interpretation:
• minimum score: 0
• maximum score: 34
• The higher the score the greater the probability of in-hospital mortality.
X =
= (0.438 * (score)) - 8.4356
probability of in-hospital mortality =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve was 0.96.
Specialty: Cardiology
