APACHE-II score and Killip class for patients with acute myocardial infarction
| Autor: | Agustín Aranda-León, María Consuelo Guia-Rambla, Juan Mercado-Martínez, E Aguilar-Alonso, Grupo Ariam, Mari Paz Fuset-Cabanes, Andrés Estivill-Torrull, Ricardo Rivera-Fernández, Ángel García-Alcántara |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Multivariate analysis Critical Care Critical Illness medicine.medical_treatment Myocardial Infarction Critical Care and Intensive Care Medicine Risk Assessment Severity of Illness Index Statistics Nonparametric law.invention Cohort Studies law Internal medicine Intensive care Outcome Assessment Health Care Severity of illness medicine Humans Prospective Studies cardiovascular diseases Myocardial infarction Sex Distribution Intensive care medicine APACHE Aged Killip class Aged 80 and over business.industry Thrombolysis Length of Stay Middle Aged Prognosis medicine.disease Survival Analysis Intensive care unit Intensive Care Units Spain Multivariate Analysis Female business Cohort study |
| Zdroj: | Intensive Care Medicine. 36:1579-1586 |
| ISSN: | 1432-1238 0342-4642 |
| Popis: | To analyse the influence on the prognosis of intensive care unit (ICU) patients with acute myocardial infarction (AMI): prognostic index score, Killip class, AMI site, thrombolysis and other variables that might improve prognostic capacity and functioning of the APACHE-II index.Cohort study using prospectively gathered ARIAM project data.ICUs from 129 Spanish hospitals.ICU-admitted AMI patients in ARIAM database during 4-year period were retrospectively studied.The sample comprised 6,458 patients, 76.8% males, age 64.97 +/- 12.56 years, APACHE-II score 9.49 +/- 7.03 points and ICU mortality 8.9%. Mortality was higher for females (p0.001), anterior AMI site (p0.001), previous AMI (p0.001), delay-to-hospital arrival180 min (p = 0.003) and non-receipt of thrombolysis (p = 0.015). ICU mortality was related to age (p0.001) and APACHE-II score (p0.001). In multivariate analysis, it was related to APACHE-II (OR 1.16), age (OR 1.05), gender (OR 1.64), previous AMI (OR 1.57), anterior AMI (OR 2.05) and delay180 min (OR 1.37). Killip class, gathered in 1,893 patients, was significantly associated with ICU mortality, and two predictive models were constructed for this group using multivariate analysis. Area under ROC curve was 0.94 in one (Killip class, age, gender, APACHE-II) versus 0.92 in the other (same variables without APACHE-II).APACHE-II score and Killip class are useful for assessing the severity of patients with AMI and are complementary. Each can be used with a few commonly gathered clinical variables to construct prognostic models to assess severity. Their joint application yields a model with excellent discrimination capacity. |
| Databáze: | OpenAIRE |
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