KAsH Score predicts long term mortality after acute myocardial
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.26/33248 |
Resumo: | Introduction: Complex risk scores have limited applicability in the assessment of patients with myocardial infarction (MI). In this work, the authors aimed to develop a simple to use clinical score to stratify the in-hospital mortality risk of patients with MI at first medical contact. Methods: In this single-center prospective registry assessing 1504 consecutively admitted patients with MI, the strongest predictors of in-hospital mortality were selected through multivariate logistic regression. The KAsH score was developed according to the following formula: KAsH=(Killip class×Age×Heart rate)/systolic blood pressure. Its predictive power was compared to previously validated scores using the DeLong test. The score was categorized and further compared to the Killip classification. Results: The KAsH score displayed excellent predictive power for in-hospital mortality, superior to other well-validated risk scores (AUC: KAsH 0.861 vs. GRACE 0.773, p<0.001) and robust in subgroup analysis. KAsH maintained its predictive capacity after adjustment for multiple confounding factors such as diabetes, heart failure, mechanical complications and bleeding (OR 1.004, 95% CI 1.001-1.008, p=0.012) and reclassified 81.5% of patients into a better risk category compared to the Killip classification. KAsH’s categorization displayed excellent mortality discrimination (KAsH 1: 1.0%, KAsH 2: 8.1%, KAsH 3: 20.4%, KAsH 4: 55.2%) and better mortality prediction than the Killip classification (AUC: KAsH 0.839 vs. Killip 0.775, p<0.0001). Conclusion: KAsH, an easy to use score calculated at first medical contact with patients with MI, displays better predictive power for in-hospital mortality than existing scores. © 2019 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espa˜na, S.L.U. This is na open access article under the CC BY-NC-ND license |
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KAsH Score predicts long term mortality after acute myocardialMyocardial infarctionPrognosisMadeira IslandPortugalscore riskKAsHIntroduction: Complex risk scores have limited applicability in the assessment of patients with myocardial infarction (MI). In this work, the authors aimed to develop a simple to use clinical score to stratify the in-hospital mortality risk of patients with MI at first medical contact. Methods: In this single-center prospective registry assessing 1504 consecutively admitted patients with MI, the strongest predictors of in-hospital mortality were selected through multivariate logistic regression. The KAsH score was developed according to the following formula: KAsH=(Killip class×Age×Heart rate)/systolic blood pressure. Its predictive power was compared to previously validated scores using the DeLong test. The score was categorized and further compared to the Killip classification. Results: The KAsH score displayed excellent predictive power for in-hospital mortality, superior to other well-validated risk scores (AUC: KAsH 0.861 vs. GRACE 0.773, p<0.001) and robust in subgroup analysis. KAsH maintained its predictive capacity after adjustment for multiple confounding factors such as diabetes, heart failure, mechanical complications and bleeding (OR 1.004, 95% CI 1.001-1.008, p=0.012) and reclassified 81.5% of patients into a better risk category compared to the Killip classification. KAsH’s categorization displayed excellent mortality discrimination (KAsH 1: 1.0%, KAsH 2: 8.1%, KAsH 3: 20.4%, KAsH 4: 55.2%) and better mortality prediction than the Killip classification (AUC: KAsH 0.839 vs. Killip 0.775, p<0.0001). Conclusion: KAsH, an easy to use score calculated at first medical contact with patients with MI, displays better predictive power for in-hospital mortality than existing scores. © 2019 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espa˜na, S.L.U. This is na open access article under the CC BY-NC-ND licenseSociedade Portuguesa de CardiologiaRepositório ComumMonteiro, Joel PonteSousa, João AdrianoSousa Mendonça, FlávioNeto, MicaelaRodrigues, RicardoGomes Serrão, MarcoSilva, BrunoMendonça, Maria IsabelFaria, Ana PaulaHenriques, EvaDrumond Freitas, António2020-09-01T16:55:27Z2020-01-212020-01-21T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.26/33248engRev Port Cardiol. 2019;38(10):681---6881646-075810.1016/j.repc.2019.12.005info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-11-10T02:16:52Zoai:comum.rcaap.pt:10400.26/33248Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T22:34:27.682402Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
KAsH Score predicts long term mortality after acute myocardial |
title |
KAsH Score predicts long term mortality after acute myocardial |
spellingShingle |
KAsH Score predicts long term mortality after acute myocardial Monteiro, Joel Ponte Myocardial infarction Prognosis Madeira Island Portugal score risk KAsH |
title_short |
KAsH Score predicts long term mortality after acute myocardial |
title_full |
KAsH Score predicts long term mortality after acute myocardial |
title_fullStr |
KAsH Score predicts long term mortality after acute myocardial |
title_full_unstemmed |
KAsH Score predicts long term mortality after acute myocardial |
title_sort |
KAsH Score predicts long term mortality after acute myocardial |
author |
Monteiro, Joel Ponte |
author_facet |
Monteiro, Joel Ponte Sousa, João Adriano Sousa Mendonça, Flávio Neto, Micaela Rodrigues, Ricardo Gomes Serrão, Marco Silva, Bruno Mendonça, Maria Isabel Faria, Ana Paula Henriques, Eva Drumond Freitas, António |
author_role |
author |
author2 |
Sousa, João Adriano Sousa Mendonça, Flávio Neto, Micaela Rodrigues, Ricardo Gomes Serrão, Marco Silva, Bruno Mendonça, Maria Isabel Faria, Ana Paula Henriques, Eva Drumond Freitas, António |
author2_role |
author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório Comum |
dc.contributor.author.fl_str_mv |
Monteiro, Joel Ponte Sousa, João Adriano Sousa Mendonça, Flávio Neto, Micaela Rodrigues, Ricardo Gomes Serrão, Marco Silva, Bruno Mendonça, Maria Isabel Faria, Ana Paula Henriques, Eva Drumond Freitas, António |
dc.subject.por.fl_str_mv |
Myocardial infarction Prognosis Madeira Island Portugal score risk KAsH |
topic |
Myocardial infarction Prognosis Madeira Island Portugal score risk KAsH |
description |
Introduction: Complex risk scores have limited applicability in the assessment of patients with myocardial infarction (MI). In this work, the authors aimed to develop a simple to use clinical score to stratify the in-hospital mortality risk of patients with MI at first medical contact. Methods: In this single-center prospective registry assessing 1504 consecutively admitted patients with MI, the strongest predictors of in-hospital mortality were selected through multivariate logistic regression. The KAsH score was developed according to the following formula: KAsH=(Killip class×Age×Heart rate)/systolic blood pressure. Its predictive power was compared to previously validated scores using the DeLong test. The score was categorized and further compared to the Killip classification. Results: The KAsH score displayed excellent predictive power for in-hospital mortality, superior to other well-validated risk scores (AUC: KAsH 0.861 vs. GRACE 0.773, p<0.001) and robust in subgroup analysis. KAsH maintained its predictive capacity after adjustment for multiple confounding factors such as diabetes, heart failure, mechanical complications and bleeding (OR 1.004, 95% CI 1.001-1.008, p=0.012) and reclassified 81.5% of patients into a better risk category compared to the Killip classification. KAsH’s categorization displayed excellent mortality discrimination (KAsH 1: 1.0%, KAsH 2: 8.1%, KAsH 3: 20.4%, KAsH 4: 55.2%) and better mortality prediction than the Killip classification (AUC: KAsH 0.839 vs. Killip 0.775, p<0.0001). Conclusion: KAsH, an easy to use score calculated at first medical contact with patients with MI, displays better predictive power for in-hospital mortality than existing scores. © 2019 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espa˜na, S.L.U. This is na open access article under the CC BY-NC-ND license |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-09-01T16:55:27Z 2020-01-21 2020-01-21T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.26/33248 |
url |
http://hdl.handle.net/10400.26/33248 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Rev Port Cardiol. 2019;38(10):681---688 1646-0758 10.1016/j.repc.2019.12.005 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Cardiologia |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Cardiologia |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799134907026374656 |