HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) View Online Appendix All Versions of this Article: j.jacc.2005.09.071v1 47/3/654    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wu, C. Articles by Jones, R. H. Search for Related Content PubMed PubMed Citation Articles by Wu, C. Articles by Jones, R. H.

EXPEDITED REVIEW

A Risk Score to Predict In-Hospital Mortality for Percutaneous Coronary Interventions

Chuntao Wu, MD, PhD^_*,,¶,||, Edward L. Hannan, PhD, FACC^_*,,¶,||, Gary Walford, MD, FACC,, John A. Ambrose, MD, FACC^,¶,||, David R. Holmes, Jr, MD, FACC^,,¶,||, Spencer B. King, III, MD, FACC^||,,¶, Luther T. Clark, MD, FACC^¶,,||, Stanley Katz, MD, FACC^#, Samin Sharma, MD, FACC^_** and Robert H. Jones, MD, FACC^,,¶,||,_*

^_* University at Albany, State University of New York, Albany, New YorkUSA
St. Joseph's Hospital, Syracuse, New York USA
St. Vincent's Hospital and Medical Center, New York, New York USA
Mayo Clinic, Rochester, Minnesota USA
^|| Fuqua Heart Center/Piedmont Hospital, Atlanta, Georgia USA
^¶ University Hospital of Brooklyn, Brooklyn, New York USA
^# North Shore-LIJ Health System, Manhasset, New York USA
^_** Mt. Sinai Medical Center, New York, New York USA
Duke University Medical Center, Durham, North Carolina USA

Manuscript received August 25, 2005; revised manuscript received September 16, 2005, accepted September 20, 2005.

^_* Reprint requests and correspondence: Dr. Robert H. Jones, Duke Clinical Research Institute, P.O. Box 17969, Durham, North Carolina 27715 (Email: jones060{at}mc.duke.edu).

OBJECTIVES: Our purpose was to develop a risk score to predict in-hospital mortality for percutaneous coronary intervention (PCI) using a statewide population-based PCI registry.

BACKGROUND: Risk scores predicting adverse outcomes after PCI have been developed from a single or a small group of hospitals, and their abilities to be generalized to other patient populations might be affected.

METHODS: A logistic regression model was developed to predict in-hospital mortality for PCI using data from 46,090 procedures performed in 41 hospitals in the New York State Percutaneous Coronary Intervention Reporting System in 2002. A risk score was derived from this model and was validated using 2003 data from New York.

RESULTS: The risk score included nine significant risk factors (age, gender, hemodynamic state, ejection fraction, pre-procedural myocardial infarction, peripheral arterial disease, congestive heart disease, renal failure, and left main disease) that were consistent with other reports. The point values for risk factors range from 1 to 9, and the total risk score ranges from 0 to 40. The observed and recalibrated predicted risks in 2003 were highly correlated for all PCI patients as well as for those in the higher-risk subgroup who suffered myocardial infarctions within 24 h before the procedure. The total risk score for mortality is strongly associated with complication rates and length of stay in the 2003 PCI data.

CONCLUSIONS: The risk score accurately predicted in-hospital death for PCI procedures using future New York data. Its performance in other patient populations needs to be further studied.

Abbreviations and Acronyms   CI = confidence interval   MI = myocardial infarction   OR = odds ratio   PCI = percutaneous coronary artery intervention

This article has been cited by other articles:

				M. A. Cavender and E. M. Ohman What Do You Need to Know Before Performing a Percutaneous Coronary Intervention? Circulation, August 5, 2008; 118(6): 609 - 611. [Full Text] [PDF]

				M. Singh, E. D. Peterson, S. Milford-Beland, J. S. Rumsfeld, and J. A. Spertus Validation of the Mayo Clinic Risk Score for In-Hospital Mortality After Percutaneous Coronary Interventions Using the National Cardiovascular Data Registry Circ Cardiovasc Intervent, August 1, 2008; 1(1): 36 - 44. [Abstract] [Full Text] [PDF]

				P. Sousa, A. S. Uva, F. Pinto, and on behalf of the investigators of PCI registry of Risk-adjustment model in health outcomes evaluation: a contribution to strengthen assessment towards quality improvement in interventional cardiology Int. J. Qual. Health Care, July 11, 2008; (2008) mzn029v1. [Abstract] [Full Text] [PDF]

				T. B. Ferguson Jr On the Evaluation of Intervention Outcome Risks for Patients With Ischemic Heart Disease Circulation, January 22, 2008; 117(3): 333 - 335. [Full Text] [PDF]

				M. Singh, B. J. Gersh, S. Li, J. S. Rumsfeld, J. A. Spertus, S. M. O'Brien, R. M. Suri, and E. D. Peterson Mayo Clinic Risk Score for Percutaneous Coronary Intervention Predicts In-Hospital Mortality in Patients Undergoing Coronary Artery Bypass Graft Surgery Circulation, January 22, 2008; 117(3): 356 - 362. [Abstract] [Full Text] [PDF]

				S. R. Dixon, C. L. Grines, and W. W. O'Neill The Year in Interventional Cardiology J. Am. Coll. Cardiol., July 17, 2007; 50(3): 270 - 285. [Full Text] [PDF]

				S. B. King III, T. Aversano, W. L. Ballard, R. H. Beekman III, M. J. Cowley, S. G. Ellis, D. P. Faxon, E. L. Hannan, J. W. Hirshfeld Jr, A. K. Jacobs, et al. ACCF/AHA/SCAI 2007 Update of the Clinical Competence Statement on Cardiac Interventional Procedures: A Report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training (Writing Committee to Update the 1998 Clinical Competence Statement on Recommendations for the Assessment and Maintenance of Proficiency in Coronary Interventional Procedures) J. Am. Coll. Cardiol., July 3, 2007; 50(1): 82 - 108. [Full Text] [PDF]

				R. H. Jones The Year in Cardiovascular Surgery J. Am. Coll. Cardiol., May 8, 2007; 49(18): 1887 - 1898. [Full Text] [PDF]

				E. L. Hannan, C. Wu, E. V. Bennett, R. E. Carlson, A. T. Culliford, J. P. Gold, R. S.D. Higgins, C. R. Smith, and R. H. Jones Risk Index for Predicting In-Hospital Mortality for Cardiac Valve Surgery Ann. Thorac. Surg., March 1, 2007; 83(3): 921 - 929. [Abstract] [Full Text] [PDF]

				H. M. Krumholz and F. A. Masoudi The Year in Epidemiology, Health Services Research, and Outcomes Research J. Am. Coll. Cardiol., November 7, 2006; 48(9): 1886 - 1895. [Full Text] [PDF]

				A Siotia and J Gunn Risk scoring for percutaneous coronary intervention: let's do it! Heart, November 1, 2006; 92(11): 1539 - 1540. [Full Text] [PDF]

				Risk Scoring for In-Hospital Mortality After PCI and CABG Journal Watch Cardiology, March 16, 2006; 2006(316): 6 - 6. [Full Text]

				W. S. Weintraub Evaluating the Risk of Coronary Surgery and Percutaneous Coronary Intervention J. Am. Coll. Cardiol., February 7, 2006; 47(3): 669 - 671. [Full Text] [PDF]