PMID: 8614117May 1, 1996Paper

Using admission characteristics to predict short-term mortality from myocardial infarction in elderly patients. Results from the Cooperative Cardiovascular Project

JAMA : the Journal of the American Medical Association
Sharon-Lise T NormandB J McNeil

Abstract

To develop a prediction model of death within 30 days of hospital admission for Medicare patients with acute myocardial infarction that would permit use of risk-adjusted mortality rates as hospital quality measures. Retrospective cohort study using data created from medical charts and administrative files. All acute care hospitals in Alabama, Connecticut, Iowa, or Wisconsin. A cohort of 14,581 patients with acute myocardial infarction covered by Medicare in 1993. The unadjusted 30-day mortality rate was 21%, ranging from 18% in Connecticut to 23% in Alabama. The 4 largest contributors to variability in mortality rates were mean arterial pressure, age, respiratory rate, and serum urea nitrogen level. The area under the receiver operator characteristic curve was 0.79 in a developmental sample of 10 936 patients and 0.78 in a validation sample of 3645 patients. Based on admission variables, we were able to explain 27% of the variability in 30-day mortality rates. During the index admission, aspirin, beta-blockers, angiotensin-converting enzyme inhibitors, and thrombolytic agents were used in 72%, 39%, 32%, and 15% of patients, respectively. Explained variation increased by 6 percentage points to 33% when drug therapies and revascu...Continue Reading

Citations

May 9, 2003·Archives of Physical Medicine and Rehabilitation·Margaret G StinemanCarl V Granger
Jul 9, 1999·Journal of Epidemiology and Community Health·T M FarleyN R Poulter
Nov 24, 2004·International Journal of Health Care Quality Assurance Incorporating Leadership in Health Services·Seetharaman HariharanJagathi Gora
Aug 18, 2005·Annales de cardiologie et d'angéiologie·F Schiele
May 29, 1997·The New England Journal of Medicine·B Starfield
Jan 28, 1999·The New England Journal of Medicine·J ChenH M Krumholz
May 26, 1999·The New England Journal of Medicine·D R ThiemannN R Powe
Nov 24, 2011·Emergency Medicine Clinics of North America·Dawn TaniguchiGraham Nichol
Apr 1, 1996·Academic Radiology·B J McNeil
May 24, 2012·TheScientificWorldJournal·Mehmet Akif CakarRamazan Akdemir
Mar 1, 2006·American Heart Journal·François SchieleJean-Pierre Bassand
Apr 25, 2006·Journal of the American College of Cardiology·Stephen D WiviottUNKNOWN National Registry of Myocardial Infarction
May 28, 2016·Journal of Interventional Cardiology·Susan M JosephUNKNOWN genVAD Working Group
Aug 6, 2016·Journal of the American College of Cardiology·Robert L McNamaraJohn A Spertus
Apr 5, 2002·Statistics in Medicine·Susan E BronskillRobert A Rosenheck
Jul 7, 2017·Circulation Journal : Official Journal of the Japanese Circulation Society·Yejin MokKunihiro Matsushita

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