Objectives To derive and validate a simple scoring system that predicts risk of 30-day mortality in patients hospitalised with acute myocardial infarction (AMI).
Methods We included 5, 524 patients with AMI who hospitalised from January 1, 1993, through December 31, 2009, at Chinese PLA General Hospital in Beijing. Age, sex, comorbidity, in-hospital mortality and complications were examined for patients primarily admitted for AMI.
Results The 30-day in-hospital mortality was 9.2% in patients. Cox regression multivariate analysis showed that a history of stroke and the complications such as cardiac shock, heart failure, ventricular tachycardia/fibrillation, pneumonia, gastrointestinal bleeding, multiple organ dysfunction syndromes, being female and being older than 50 were the only independent predictors of in-hospital mortality. Using the regression coefficient as a benchmark, we calculated a convenient score. In the validation dataset, the 1,677 patients with the lowest scores had a mortality rate of 1.5% and the 1,454 patients with the highest scores had a mortality rate of 24.2%.
Conclusions The study illustrates that a history of stroke, the complications, gender and age (older than 50) have proved to be a major prognostic marker for immediate poor outcome in the patients with AMI. The score may help to identify patients who are more likely to have a risk of in-hospital mortality within 30-days.
- Acute myocardial infarction (AMI)
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