title: Prediction of survival in patients with acute myocardial infarction. A clinical study on 100 consecutive patients.
abstract: Expected survival after acute myocardial infarction (AMI) in 100 consecutive patients was predicted by three doctors and two nurses at the time of discharge from a CCU. Predictions were compared with various coronary prognostic indices (CPI) and were found to be too optimistic for the first 9 months. Experienced physicians made more reliable predictions than junior physicians and nurses. All patients with a predicted survival of more than 10 years were alive after 1 year and all with predicted death within one month died during the first year. Intermediate predictions were unreliable with reference to the one-year survival. Regardless of which CPI was used, a low index score carried a very low one-year mortality and high index a high mortality. Intermediate index scores were unreliable. A comparison between the predictions and index scores showed that there was no difference in sensitivity and specificity between the methods. Our study thus shows that patients with either a very good or a very poor prognosis will be identified regardless of the method used. The problem of identifying the individual with an intermediate risk remains to be solved.
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002983:Clinical Competence; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality*; D011379:Prognosis