Predicting 1-Year Mortality on Admission Using the Mayo Cardiac Intensive Care Unit Admission Risk Score

Breen, Thomas; Padkins, Mitchell; Bennett, Courtney; Anavekar, Nandan S.; Murphy, Joseph G.; Bell, Malcolm R.; Barsness, Gregory W.; Jentzer, Jacob C.

doi:10.1016/j.mayocp.2021.01.031

Cited by 6 publications

(4 citation statements)

References 31 publications

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“…A stratification analysis was conducted to explore whether the association between the CHA 2 DS 2 -VASc score and 30-mortality differed across various subgroups classified by sepsis, AF/ AFL, ethnicity, comorbidities, vasoactive drug use, diuretic use, proton pump inhibitor (PPI) use and so on. Moreover, the restricted cubic splines (RCS) were used to visualize the association between RDW, 12 BUN, 13 platelet, 14 WBC, 15 hemoglobin, 16,17 phosphorus, 18 glucose, 19 potassium, 20 sodium 21 and 30-day mortality in the 0-3 score versus the 4-9 score groups after PSM. The number of knots was set to four, located at the fifth, 35th, 65th, and 95th percentiles according to both Harrell recommendations.…”

Section: Methodsmentioning

confidence: 99%

The Association Between High CHA₂DS₂-VASc Scores and Short and Long-Term Mortality for Coronary Care Unit Patients

Cheng

Kang

Lin

et al. 2022

Clin Appl Thromb Hemost

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Background The CHA2DS2-VASc score has been associated with the prognosis of cardiovascular diseases. This study aimed to explore the association between the CHA2DS2-VASc score and all-cause mortality in coronary care unit (CCU) patients. Methods The study was based on the Medical Information Mart for Intensive Care (MIMIC) III database. CCU patients were divided into two groups according to CHA2DS2-VASc score: 0-3 (low risk)，4-9 (intermediate and high risk). The primary outcome was 30-day mortality, and the secondary endpoints included in-hospital, 1-year, and 5-year mortality. Propensity score matching (PSM) and sensitivity analyzes for the confounders were also performed. The restricted cubic splines flexibility model was used to demonstrate the relation between red blood cell volume distribution width (RDW), blood urea nitrogen (BUN), platelet, white blood cell (WBC), hemoglobin, phosphorus, glucose, potassium, sodium and 30-day mortality in the 0-3 score versus the 4-9 score groups after PSM. Results Among 4491 eligible patients, 988 patients with low CHA2DS2-VASc scores and 988 patients with intermediate and high CHA2DS2-VASc scores had similar propensity scores and were included in the analyzes. In the survival analysis, the patients with intermediate and high CHA2DS2-VASc scores were associated with higher 30-day mortality [hazard ratio (HR): 1.11; 95% confidence interval (CI), 1.02–1.20, P = .014], 1-year mortality [HR: 1.13; 95%CI, 1.06–1.19, P < .001], and 5-year mortality [HR: 1.13; 95%CI, 1.07–1.18, P < .001]. The interaction for 30-day mortality among subgroups was not significant between the 0-3 score versus the 4-9 score groups. The restricted cubic splines for 30-day mortality demonstrated an L-shaped trajectory for platelets and hemoglobin, a J-shaped trajectory for WBC, glucose and potassium, and a U-shaped trajectory for sodium, respectively (all nonlinear P <.001). Conclusions A high CHA2DS2-VASc score was an independent risk for 30-day, 1-year, and 5-year mortality for CCU patients.

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Section: Methodsmentioning

confidence: 99%

The Association Between High CHA₂DS₂-VASc Scores and Short and Long-Term Mortality for Coronary Care Unit Patients

Cheng

Kang

Lin

et al. 2022

Clin Appl Thromb Hemost

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“…20 Recently, a new cardiac ICU-specific score, M-CARS, using seven variables available at the time of ICCU admission, has been derived and validated at Mayo Clinic with excellent discrimination in predicting in-hospital and 1-year mortality. 11,21 In our population, M-CARS was found to be related to the length of stay with acceptable discrimination of mortality. Our results confirm the good predictive performance of M-CARS that has been externally validated only in an Asiatic tertiary ICCU.…”

Section: Cardiac Icu Scoresmentioning

confidence: 66%

Clinical complexity of an Italian cardiovascular intensive care unit: the role of mortality and severity risk scores

Troisi,

Guida,

Vitulano

et al. 2024

Journal of Cardiovascular Medicine

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Aims The identification of patients at greater mortality risk of death at admission into an intensive cardiovascular care unit (ICCU) has relevant consequences for clinical decision-making. We described patient characteristics at admission into an ICCU by predicted mortality risk assessed with noncardiac intensive care unit (ICU) and evaluated their performance in predicting patient outcomes. Methods A total of 202 consecutive patients (130 men, 75 ± 12 years) were admitted into our tertiary-care ICCU in a 20-week period. We evaluated, on the first 24 h data, in-hospital mortality risk according to Acute Physiology and Chronic Health Evaluation II (APACHE II) and Simplified Acute Physiology Score 3 (SAPS 3); Sepsis related Organ Failure Assessment (SOFA) Score and the Mayo Cardiac intensive care unit Admission Risk Score (M-CARS) were also calculated. Results Predicted mortality was significantly lower than observed (5% during ICCU and 7% at discharge) for APACHE II and SAPS 3 (17% for both scores). Mortality risk was associated with older age, more frequent comorbidities, severe clinical presentation and complications. The APACHE II, SAPS 3, SOFA and M-CARS had good discriminative ability in distinguishing deaths and survivors with poor calibration of risk scores predicting mortality. Conclusion In a recent contemporary cohort of patients admitted into the ICCU for a variety of acute and critical cardiovascular conditions, scoring systems used in general ICU had good discrimination for patients’ clinical severity and mortality. Available scores preserve powerful discrimination but the overestimation of mortality suggests the importance of specific tailored scores to improve risk assessment of patients admitted into ICCUs.

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“…Importantly, as of today there are numerous models predicting general ICU mortality including APACHE, SAPS II, and othes 29 but few if any such models for ICCU patients. 35 Accordingly, the result of the current study might held develop a contemporary mortality model for ICCU patients as well.…”

Section: Discussionmentioning

confidence: 92%

D-Dimer as a Prognostic Factor in a Tertiary Center Intensive Coronary Care Unit

Rav

Taha

Turyan

et al. 2022

Clin Appl Thromb Hemost

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Introduction D-dimer is a small protein fragment produced during fibrinolysis. High D-dimer levels were shown to have prognostic impact in critically ill patients. Nevertheless, data regarding D-dimer's prognostic impact among tertiary care intensive coronary care unit (ICCU) patients is scarce. Material and method All patients admitted to the ICCU between 1-12/2020 were prospectively included. Based on admission D-dimer level, patients were categorized into low and high D-dimer groups (< 500 ng/ml and ≥ 500 ng/ml) and also to age-adjusted D-dimer cutoff (500 ng/ml for ages ≤ 50 years old and age*10 for ages>50 years old). Results and discussion A total of 959 consecutive patients were included, including 296 (27.4%) and 663 (61.3%) patients with low and high D-Dimer levels, respectively. Patients with high D-dimer level were older compared with patients with low D-dimer level (age 70.4 ± 15 and 59 ± 13 years, p = 0.004) and had more comorbidities. The most common primary diagnosis on admission among the low D-dimer group was acute coronary syndrome (ACS) (74.3%), while in the high D-dimer group it was a combination of ACS (33.6%), cardiac structural interventions (26.7%) and various arrhythmias (21.1%). High D-dimer levels were associated with increased mortality rate, even after adjustment for age, gender, comorbidities and left ventricular ejection fraction (LVEF). High D-dimer levels were independently associated with increased overall 1-year mortality rate (HR = 5.8; 95% CI; 1.7-19.1; p = 0.004). Conclusion Elevated D-dimer levels on admission in ICCU patients is an independently poor prognostic factor for in-hospital morbidity and 1-year overall mortality rate following hospitalization.

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Predicting 1-Year Mortality on Admission Using the Mayo Cardiac Intensive Care Unit Admission Risk Score

Cited by 6 publications

References 31 publications

The Association Between High CHA₂DS₂-VASc Scores and Short and Long-Term Mortality for Coronary Care Unit Patients

The Association Between High CHA₂DS₂-VASc Scores and Short and Long-Term Mortality for Coronary Care Unit Patients

Clinical complexity of an Italian cardiovascular intensive care unit: the role of mortality and severity risk scores

D-Dimer as a Prognostic Factor in a Tertiary Center Intensive Coronary Care Unit

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Predicting 1-Year Mortality on Admission Using the Mayo Cardiac Intensive Care Unit Admission Risk Score

Cited by 6 publications

References 31 publications

The Association Between High CHA2DS2-VASc Scores and Short and Long-Term Mortality for Coronary Care Unit Patients

The Association Between High CHA2DS2-VASc Scores and Short and Long-Term Mortality for Coronary Care Unit Patients

Clinical complexity of an Italian cardiovascular intensive care unit: the role of mortality and severity risk scores

D-Dimer as a Prognostic Factor in a Tertiary Center Intensive Coronary Care Unit

Contact Info

Product

Resources

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The Association Between High CHA₂DS₂-VASc Scores and Short and Long-Term Mortality for Coronary Care Unit Patients

The Association Between High CHA₂DS₂-VASc Scores and Short and Long-Term Mortality for Coronary Care Unit Patients