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Predictors of hospital mortality in the global registry of acute coronary events.

Publication ,  Journal Article
Granger, CB; Goldberg, RJ; Dabbous, O; Pieper, KS; Eagle, KA; Cannon, CP; Van De Werf, F; Avezum, A; Goodman, SG; Flather, MD; Fox, KAA ...
Published in: Arch Intern Med
October 27, 2003

BACKGROUND: Management of acute coronary syndromes (ACS) should be guided by an estimate of patient risk. OBJECTIVE: To develop a simple model to assess the risk for in-hospital mortality for the entire spectrum of ACS treated in general clinical practice. METHODS: A multivariable logistic regression model was developed using 11 389 patients (including 509 in-hospital deaths) with ACS with and without ST-segment elevation enrolled in the Global Registry of Acute Coronary Events (GRACE) from April 1, 1999, through March 31, 2001. Validation data sets included a subsequent cohort of 3972 patients enrolled in GRACE and 12 142 in the Global Use of Strategies to Open Occluded Coronary Arteries IIb (GUSTO-IIb) trial. RESULTS: The following 8 independent risk factors accounted for 89.9% of the prognostic information: age (odds ratio [OR], 1.7 per 10 years), Killip class (OR, 2.0 per class), systolic blood pressure (OR, 1.4 per 20-mm Hg decrease), ST-segment deviation (OR, 2.4), cardiac arrest during presentation (OR, 4.3), serum creatinine level (OR, 1.2 per 1-mg/dL [88.4- micro mol/L] increase), positive initial cardiac enzyme findings (OR, 1.6), and heart rate (OR, 1.3 per 30-beat/min increase). The discrimination ability of the simplified model was excellent with c statistics of 0.83 in the derived database, 0.84 in the confirmation GRACE data set, and 0.79 in the GUSTO-IIb database. CONCLUSIONS: Across the entire spectrum of ACS and in general clinical practice, this model provides excellent ability to assess the risk for death and can be used as a simple nomogram to estimate risk in individual patients.

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Published In

Arch Intern Med

DOI

ISSN

0003-9926

Publication Date

October 27, 2003

Volume

163

Issue

19

Start / End Page

2345 / 2353

Location

United States

Related Subject Headings

  • Risk Factors
  • Risk Assessment
  • Prognosis
  • Myocardial Ischemia
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Logistic Models
  • Humans
  • Hospital Mortality
 

Citation

APA
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ICMJE
MLA
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Granger, C. B., Goldberg, R. J., Dabbous, O., Pieper, K. S., Eagle, K. A., Cannon, C. P., … Global Registry of Acute Coronary Events Investigators, . (2003). Predictors of hospital mortality in the global registry of acute coronary events. Arch Intern Med, 163(19), 2345–2353. https://doi.org/10.1001/archinte.163.19.2345
Granger, Christopher B., Robert J. Goldberg, Omar Dabbous, Karen S. Pieper, Kim A. Eagle, Christopher P. Cannon, Frans Van De Werf, et al. “Predictors of hospital mortality in the global registry of acute coronary events.Arch Intern Med 163, no. 19 (October 27, 2003): 2345–53. https://doi.org/10.1001/archinte.163.19.2345.
Granger CB, Goldberg RJ, Dabbous O, Pieper KS, Eagle KA, Cannon CP, et al. Predictors of hospital mortality in the global registry of acute coronary events. Arch Intern Med. 2003 Oct 27;163(19):2345–53.
Granger, Christopher B., et al. “Predictors of hospital mortality in the global registry of acute coronary events.Arch Intern Med, vol. 163, no. 19, Oct. 2003, pp. 2345–53. Pubmed, doi:10.1001/archinte.163.19.2345.
Granger CB, Goldberg RJ, Dabbous O, Pieper KS, Eagle KA, Cannon CP, Van De Werf F, Avezum A, Goodman SG, Flather MD, Fox KAA, Global Registry of Acute Coronary Events Investigators. Predictors of hospital mortality in the global registry of acute coronary events. Arch Intern Med. 2003 Oct 27;163(19):2345–2353.

Published In

Arch Intern Med

DOI

ISSN

0003-9926

Publication Date

October 27, 2003

Volume

163

Issue

19

Start / End Page

2345 / 2353

Location

United States

Related Subject Headings

  • Risk Factors
  • Risk Assessment
  • Prognosis
  • Myocardial Ischemia
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Logistic Models
  • Humans
  • Hospital Mortality