title: A hospital discharge risk score for 1-year all-cause mortality or non-fatal cardiovascular events in patients with lower-extremity peripheral artery disease, with and without revascularisation.
abstract: OBJECTIVE
  This study aims to determine a hospital discharge prognostic risk score for patients with lower-extremity peripheral artery disease (PAD) with and without revascularisation.
  
  
  METHODS
  A prognostic score on mortality or non-fatal cardiovascular events was determined using the database of a multicentre prospective study enrolling consecutive patients hospitalised for PAD (COhorte de Patients ARTeriopathes, COPART).
  
  
  RESULTS
  We analysed the data of 640 patients in the derivation cohort and 517 in the validation cohort. The risk score (and corresponding points) included the following factors: age 75-84 years (+2), ≥ 85 years (+3); previous myocardial infarction (+1); creatinine clearance: ≤ 30 ml min(-1) 1.73 m⁻² (+1.5), 0.30-0.59 (+1), ankle-brachial index: <0.3 (+2), 0.3-0.49 (+1.5) and >1.3 (+2); C-reactive protein (CRP) ≥ 70 mg l⁻¹ (+2); and association of statins, anti-platelet agents and renin-angiotensin system inhibitors (-1.5). The frequency of the composite outcome increased significantly with the predicted risk: low risk (≤ 0 point), 2%; medium (0.5-2 points), 12.8%; high (2.5-4 points), 23%; very high (≥ 4.5 points): 42.2%. The model had a good performance in terms of discrimination (C-statistic 0.74 and 0.76) and calibration (Hosmer-Lemeshow 0.65).
  
  
  CONCLUSIONS
  We propose the validated COPART risk score for hospitalised severe PAD. This prognostic risk score is based on six variables easily identifiable in clinical practice. Our study highlights the favourable prognostic impact of the prescription at discharge of combined drug therapies.
authors: Department of Vascular Medicine, Rangueil University Hospital, Toulouse, France. prosnicolas@yahoo.fr
authors: N
authors: N
authors: Pros
authors: J P
authors: JP
authors: Cambou
authors: V
authors: V
authors: Aboyans
authors: J
authors: J
authors: Malloizel Delaunay
authors: J
authors: J
authors: Constans
authors: P
authors: P
authors: Lacroix
authors: B
authors: B
authors: Saint Lèbes
authors: E
authors: E
authors: Curaudeau
authors: A
authors: A
authors: Bura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications* / Q000453:epidemiology* / Q000401:mortality; D002423:Cause of Death; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D058729:Peripheral Arterial Disease / Q000150:complications* / Q000601:surgery; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D013997:Time Factors; D014656:Vascular Surgical Procedures