Evaluation of prognostic scale Thrombolysis In Myocardial Infarction and Killip. An ST-elevation myocardial infarction new scale
| Autor: | Maria Dolores Arias-Verdú, Emilio Sánchez-Cantalejo, Teresa García-Paredes, E Aguilar-Alonso, José Andrés Arboleda-Sánchez, Antonio Vera-Almazán, Ricardo Rivera-Fernández, Victoria Olea-Jiménez, Mari Paz Fuset-Cabanes |
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| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Myocardial Infarction Risk Assessment law.invention Electrocardiography law Angioplasty Internal medicine Medicine Humans Thrombolytic Therapy Myocardial infarction Hospital Mortality Prospective Studies cardiovascular diseases Prospective cohort study Aged medicine.diagnostic_test business.industry General Medicine Odds ratio Thrombolysis Length of Stay Middle Aged medicine.disease Prognosis Intensive care unit Surgery Intensive Care Units Spain Emergency Medicine Cardiology business TIMI Biomarkers |
| Zdroj: | AMERICAN JOURNAL OF EMERGENCY MEDICINE r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe instname |
| ISSN: | 0735-6757 |
| Popis: | Background: Prognostic systems are complex. So it is necessary to find tools, which are easy to use and have good calibration and discrimination. Objectives: The objective of this study is to evaluate the usefulness of Killip, Thrombolysis In Myocardial Infarction (TIMI), and age to develop a new prognostic scale for patients with ST-elevation myocardial infarction (STEMI). Methods: The study population included all patients with STEMI consecutively admitted to the Intensive Care Unit of Carlos Haya Hospital, Malaga, Spain. Top variables included are Killip and TIMI, hospital mortality, intensive care unit stay, treatment received, and care times intervals. Results: The results are 806 patients; 75.6% men; age 63.11 +/- 12.83 years old; TIMI, 3.57 +/- 2.38; Killip I, 81.4%; and hospital mortality, 11.3%. Mortality increased in relation to age, TIMI, and Killip (P < .001). Receiver operating characteristic (ROC) area for TIMI is 0.832 (0.786-0.878) and Killip, 0.757 (0.698-0.822). Thrombolysis In Myocardial Infarction classification was associated with Killip and age by multiple linear regression. Patients were stratified into 5 groups according to Killip and age: Killip I and younger than 65 years (n = 369; mortality, 1.4%; odds ratio [OR], 1), Killip I and 65 to 75 years old (n = 173; mortality, 6.9%; OR, 5.43 [1.88-15.66]), Killip I and older than 75 years (n = 112; mortality, 18.9%; OR, 13.03 [4.69-36.21]), Killip II to III (n = 129; mortality, 31%; OR, 22.72 [12.55-85.29]), Killip IV (n = 20; mortality, 80%; OR, 291.2 [71.32-1189]). ROC area is 0.84 (0.798-0.883). We created a scale with scores based on the beta coefficient of logistical regression. Conclusions: The TIMI scale discriminated hospital mortality correctly for STEMI. It performed better than Killip alone and similar to a simple model that included age and Killip. The 2-variable model consists of a simple scale with 5 categories. (C) 2014 Elsevier Inc. All rights reserved. |
| Databáze: | OpenAIRE |
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