Hospital discharge risk score system for the assessment of clinical outcomes in patients with acute myocardial infarction (Korea Acute Myocardial Infarction Registry [KAMIR] score).
Assessment of risk at time of discharge could be a useful tool for guiding postdischarge management. The aim of this study was to develop a novel and simple assessment tool for better hospital discharge risk stratification. The study included 3,997 hospital-discharged patients with acute myocardial infarction who were enrolled in the nationwide prospective Korea Acute Myocardial Infarction Registry-1 (KAMIR-1) from November 2005 through December 2006. The new risk score system was tested in 1,461 hospital-discharged patients who were admitted from January 2007 through January 2008 (KAMIR-2). The new risk score system was compared to the Global Registry of Acute Coronary Events (GRACE) postdischarge risk model during a 12-month clinical follow-up. During 1-year follow-up, all-cause death occurred in 228 patients (5.7%) and 81 patients (5.5%) in the development and validation cohorts, respectively. The new risk score (KAMIR score) was constructed using 6 independent variables related to the primary end point using a multivariable Cox regression analysis: age, Killip class, serum creatinine, no in-hospital percutaneous coronary intervention, left ventricular ejection fraction, and admission glucose based on multivariate-adjusted risk relation. The KAMIR score demonstrated significant differences in its predictive accuracy for 1-year mortality compared to the GRACE score for the developmental and validation cohorts. In conclusion, the KAMIR score for patients with acute myocardial infarction is a simpler and better risk scoring system than the GRACE hospital discharge risk model in prediction of 1-year mortality.
Chonnam National University Hospital, Gwangju, South Korea.
Hyun Kuk
HK
Kim
Myung Ho
MH
Jeong
Youngkeun
Y
Ahn
Jong Hyun
JH
Kim
Shung Chull
SC
Chae
Young Jo
YJ
Kim
Seung Ho
SH
Hur
In Whan
IW
Seong
Taek Jong
TJ
Hong
Dong Hoon
DH
Choi
Myeong Chan
MC
Cho
Chong Jin
CJ
Kim
Ki Bae
KB
Seung
Wook Sung
WS
Chung
Yang Soo
YS
Jang
Seung Woon
SW
Rha
Jang Ho
JH
Bae
Jeong Gwan
JG
Cho
Seung Jung
SJ
Park
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002423:Cause of Death; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D016757:Death, Sudden, Cardiac / Q000453:epidemiology; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate; D006801:Humans; D007723:Korea; D008297:Male; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood / Q000401:mortality* / Q000628:therapy; D010351:Patient Discharge / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries / Q000706:statistics & numerical data*; D018570:Risk Assessment / Q000706:statistics & numerical data*; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000401:mortality / Q000628:therapy
D001786:Blood Glucose; D003404:Creatinine