Modified Mid America Heart Institute Coronary Care Unit scoring system – a new comprehensive prognostic index for Coronary Care Unit patients
Dhanunjaya Lakkireddy, James Vacek, William Harris, Manohar Gowda, Kaushalya Pendyala, Caroline Murray
Med Sci Monit 2005; 11(3): CR95-99
Background: Prediction of long-term outcomes for patients presenting with cardiac events is important, but few predictive instruments are available. We previously developed an innovative scoring system,
the Mid America Heart Institute (MAHI) Coronary Care Unit (CCU) scoring system, for quantifying outcomes of patients admitted to the CCU, using clinical events rather than solely physiologic and laboratory variables. The objective of our study was to validate a refi ned version of this system (MAHI-2) and to explore its prognostic value, we have postulated that patients with high MAHI scores would have higher mortality and morbidity in 1-year follow-up.
Material/Methods: 154 patients admitted to the CCU were followed and assigned a MAHI score based on key clinical variables and events. The patients were followed for 1 year and outcomes were analyzed based on MAHI score quartiles.
Results: The mean MAHI-2 score was 14±8. Over one year, 34 patients died, 13 suffered myocardial infarction, 12 had coronary artery bypass graft, 6 had percutaneous transluminal coronary angiography, 37 had a cardiovascular-related admission, and a total of 48 (31%) suffered >1 major adverse cardiac event (MACE – death/myocardial infarction/revascularization). MACE rates increased progressively by MAHI-2 score quartile (from 21% for those in the lowest quartile, to 42% in the highest quartile; p=0.22). The risk of death was more strongly correlated with MAHI-2 score, with patients
in the highest quartile being at 6-fold greater risk for death in 1 year than those in the lowest quartile (p
Keywords: Coronary Care Units, Coronary Disease - diagnosis, Coronary Disease - mortality, Coronary Disease - therapy, Follow-Up Studies, Humans, Predictive Value of Tests, Prognosis, Reproducibility of Results, Retrospective Studies, Survival Analysis, Survival Rate, Time Factors, Treatment Outcome, United States, Coronary Care Units, Coronary Disease - therapy, Follow-Up Studies, Humans, Predictive Value of Tests, Prognosis, Reproducibility of Results, Retrospective Studies, Survival Analysis, Survival Rate, Time Factors, Treatment Outcome, United States