Abstract 14114: Evaluation for Predicting the Risk of In-Hospital Mortality in Patients With Acute Myocardial Infarction Using Multicenter Registry Database in Japan
Objectives: There was no established measurement of in-hospital mortality for acute myocardial infarction (AMI) in Japan. We investigate to develop and validate the risk adjustment in-hospital mortality model in the patients with AMI.
Methods: We established the multicenter registry to collect data of the patients with AMI. As the derivation cohort (16A-1), 1897 patients with AMI were enrolled into a registry from 27 hospitals during 2005 and 2006. As the validation cohort (19A-2), 1826 patients with AMI enrolled from the same hospitals during 2008 and 2009. Logistic regression was used for risk model. The accuracy of the model was measured using the c-index with the validation cohort (19A-2).
Results: In the derivation cohort, multivariate analysis showed independent predictors of inhospital death which were age (odds ratios 1.84), female gender (1.67), smoking (0.69), hyperlipidemia (0.50), peak Log CPK (1.78), Killip classification more than 2 (3.06), time from onset to hospitalization (1.03) and anterior of infarct location (1.63). The risk model of in-hospital mortality was estimated as 1/(1+exp(-βx)); in-hospital mortality =1/(1+(11.902 - 0.607×age - 0.512×gender + 0.37×smoking + 0.696×hyperlipidemia - 0.579×Log peakCPK - 1.12 ×Killip classification - 0.03×time from onset to hospitalization - 0.491×anterior of infarct location, these clinical or statistical relevant factors were finalized by checking goodness-of-fit and calibration. Using the validation cohort, C-index for in-hospital mortality prediction for patients with AMI was 0.89 (95%CI: 0.84-0.93). There was no clear relation between hospital factors and in-hospital mortality.
Conclusion: This is a first report, the risk adjustment in-hospital mortality model in the patients with AMI and showed good discrimination in Japan.
- © 2011 by American Heart Association, Inc.