A clinical risk score to predict the time to first appropriate device therapy in recipients of implantable cardioverter defibrillators.
BACKGROUND
To develop a risk score to predict the occurrence of appropriate defibrillator [implantable cardioverter-defibrillator (ICD)] therapies. A simple clinical score predicting the risk of appropriate ICD therapy is lacking.


METHODS
A Cox regression model was developed from a database of ICD patients at a single tertiary center to predict the time to appropriate ICD therapy defined as shock or antitachycardia pacing. A risk score was derived from this model using half of the database and was validated using the other half.


RESULTS
A total of 399 patients were entered into the database between July 2001 and February 2004. There were no statistically significant differences between the derivation (n = 200) and validation (n = 199) groups in any of the demographic or clinical variables recorded. The risk score included three independent variables: indication for ICD implantation (P = 0.03), serum creatinine level (P = 0.015), and QRS width (P = 0.028). The observed risk scores were highly predictive of time to ICD therapy in the validation group (P = 0.02).


CONCLUSIONS
We describe a new clinical risk score that predicts the time to appropriate device therapy in ICD recipients of a single tertiary center hospital. The performance of this risk score needs to be investigated prospectively in a larger patient population.
Hreybe
Haitham
H
Cardiovascular Electrophysiology Section, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.
Saba
Samir
S
D001145:Arrhythmias, Cardiac / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control*; D003401:Creatine / Q000097:blood; D017147:Defibrillators, Implantable / Q000706:statistics & numerical data*; D018572:Disease-Free Survival; D004554:Electric Countershock / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010414:Pennsylvania / Q000453:epidemiology; D011379:Prognosis; D016016:Proportional Hazards Models; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity
D003401:Creatine