Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Sci Rep. 2018 Jun 13;8(1):9082. doi: 10.1038/s41598-018-26861-z.
Risk stratification of patients with acute myocardial infarction (AMI) is of clinical significance. Although there are many existing risk scores, periodic update is required to reflect contemporary patient profile and management. The present study aims to develop a risk model to predict in-hospital death among contemporary AMI patients as soon as possible after admission. We included 23417 AMI patients from China Acute Myocardial Infarction (CAMI) registry from January 2013 to September 2014 and extracted relevant data. Patients were divided chronologically into a derivation cohort (n = 17563) to establish the multivariable logistic regression model and a validation cohort (n = 5854) to validate the risk score. Sixteen variables were identified as independent predictors of in-hospital death and were used to establish CAMI risk model and score: age, gender, body mass index, systolic blood pressure, heart rate, creatinine level, white blood cell count, serum potassium, serum sodium, ST-segment elevation on ECG, anterior wall involvement, cardiac arrest, Killip classification, medical history of hypertension, medical history of hyperlipidemia and smoking status. Area under curve value of CAMI risk model was 0.83 within the derivation cohort and 0.84 within the validation cohort. We developed and validated a risk score to predict in-hospital death risk among contemporary AMI patients.
急性心肌梗死(AMI)患者的风险分层具有临床意义。尽管有许多现有的风险评分,但需要定期更新以反映当代患者的特征和管理方式。本研究旨在开发一种风险模型,以预测入院后尽快住院死亡的当代 AMI 患者。我们纳入了 2013 年 1 月至 2014 年 9 月中国急性心肌梗死(CAMI)登记研究中的 23417 例 AMI 患者,并提取了相关数据。患者按时间顺序分为推导队列(n=17563),以建立多变量逻辑回归模型和验证队列(n=5854),以验证风险评分。确定了 16 个变量作为住院死亡的独立预测因子,并用于建立 CAMI 风险模型和评分:年龄、性别、体重指数、收缩压、心率、肌酐水平、白细胞计数、血清钾、血清钠、心电图上的 ST 段抬高、前壁受累、心脏骤停、Killip 分级、高血压病史、高血脂病史和吸烟状况。CAMI 风险模型的曲线下面积值在推导队列中为 0.83,在验证队列中为 0.84。我们开发并验证了一种风险评分,以预测当代 AMI 患者的住院死亡风险。