title: Evaluation of prognostic scale Thrombolysis In Myocardial Infarction and Killip. An ST-elevation myocardial infarction new scale.
abstract: BACKGROUND
  Prognostic systems are complex. So it is necessary to find tools, which are easy to use and have good calibration and discrimination.
  
  
  OBJECTIVE
  The objective of this study is to evaluate the usefulness of Killip, Thrombolysis In Myocardial Infarction (TIMI), and age to develop a new prognostic scale for patients with ST-elevation myocardial infarction (STEMI).
  
  
  METHODS
  The study population included all patients with STEMI consecutively admitted to the Intensive Care Unit of Carlos Haya Hospital, Malaga, Spain. Top variables included are Killip and TIMI, hospital mortality, intensive care unit stay, treatment received, and care times intervals.
  
  
  RESULTS
  The results are 806 patients; 75.6% men; age 63.11 ± 12.83 years old; TIMI, 3.57 ± 2.38; Killip I, 81.4%; and hospital mortality, 11.3%. Mortality increased in relation to age, TIMI, and Killip (P < .001). Receiver operating characteristic (ROC) area for TIMI is 0.832 (0.786-0.878) and Killip, 0.757 (0.698-0.822). Thrombolysis In Myocardial Infarction classification was associated with Killip and age by multiple linear regression. Patients were stratified into 5 groups according to Killip and age: Killip I and younger than 65 years (n = 369; mortality, 1.4%; odds ratio [OR], 1), Killip I and 65 to 75 years old (n = 173; mortality, 6.9%; OR, 5.43 [1.88-15.66]), Killip I and older than 75 years (n = 112; mortality, 18.9%; OR, 13.03 [4.69-36.21]), Killip II to III (n = 129; mortality, 31%; OR, 22.72 [12.55-85.29]), Killip IV (n = 20; mortality, 80%; OR, 291.2 [71.32-1189]). ROC area is 0.84 (0.798-0.883). We created a scale with scores based on the β coefficient of logistical regression.
  
  
  CONCLUSIONS
  The TIMI scale discriminated hospital mortality correctly for STEMI. It performed better than Killip alone and similar to a simple model that included age and Killip. The 2-variable model consists of a simple scale with 5 categories.
authors.affiliation: Coronary Care Unit, Hospital Carlos Haya, Málaga, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: García-Paredes
authors.affiliation: Intensive Care Unit, Hospital Infanta Margarita Cabra, Córdoba, Spain. Electronic address: eaguia@yahoo.es.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Aguilar-Alonso
authors.affiliation: Coronary Care Unit, Hospital Carlos Haya, Málaga, Spain.
authors.forename: José Andrés
authors.initials: JA
authors.lastname: Arboleda-Sánchez
authors.affiliation: Coronary Care Unit, Hospital Carlos Haya, Málaga, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Vera-Almazán
authors.affiliation: Intensive Care Unit, Hospital Carlos Haya, Málaga, Spain.
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Arias-Verdú
authors.affiliation: Coronary Care Unit, Hospital Carlos Haya, Málaga, Spain.
authors.forename: Victoria
authors.initials: V
authors.lastname: Oléa-Jiménez
authors.affiliation: Intensive Care Unit, Hospital La Fé, Valencia, Spain.
authors.forename: Mari Paz
authors.initials: MP
authors.lastname: Fuset-Cabanes
authors.affiliation: CIBRESP, Andalusian School of Public Health, Granada, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Sánchez-Cantalejo
authors.affiliation: Intensive Care Unit, Hospital Carlos Haya, Málaga, Spain.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Rivera-Fernández
mesh_terms: D000368:Aged; D017130:Angioplasty; D015415:Biomarkers / Q000097:blood; D004562:Electrocardiography; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy*; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D013030:Spain / Q000453:epidemiology; D015912:Thrombolytic Therapy
chemical_list: D015415:Biomarkers