The Toronto score for in-hospital mortality after percutaneous coronary interventions

Background Benchmarking the performance of providers is an increasing priority in many health care economies. In-hospital mortality represents an important and uniformly assessed measure on which to examine the outcome of percutaneous coronary intervention (PCI). Most existing prediction models of i...

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Bibliographic Details
Published in:The American heart journal 2009, Vol.157 (1), p.156-163
Main Authors: Chowdhary, Saqib, MD, PhD, Ivanov, Joan, PhD, Mackie, Karen, RN, Seidelin, Peter H., MD, Džavík, Vladimír, MD
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Angioplasty, Balloon, Coronary - mortality
Biological and medical sciences
Cardiology
Cardiology. Vascular system
Cardiovascular
Colleges & universities
Diseases of the cardiovascular system
Female
Heart attacks
Hospital Mortality
Humans
Male
Medical sciences
Middle Aged
Mortality
Multivariate Analysis
Ontario
Prospective Studies
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Risk Assessment
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Summary:Background Benchmarking the performance of providers is an increasing priority in many health care economies. In-hospital mortality represents an important and uniformly assessed measure on which to examine the outcome of percutaneous coronary intervention (PCI). Most existing prediction models of in-hospital mortality after PCI were derived from 1990s data, and their current relevance is uncertain. Methods From consecutive PCIs performed during 2000-2008, derivation and validation cohorts of 10,694 and 5,347 patients, respectively, were analyzed. Logistic regression for in-hospital death yielded integer risk weights for each independent predictor variable. These were summed for each patient to create the Toronto PCI risk score. Results Death occurred in 1.3% of patients. Independent predictors with associated risk weights in parentheses were as follows: age 40 to 49 y (1), 50 to 59 y (2), 60 to 69 y (3), 70 to 79 y (4), and ≥80 y (5); diabetes (2); renal insufficiency (2); New York Heart Association class 4 (3); left ventricular ejection fraction
ISSN:0002-8703
1097-6744
DOI:10.1016/j.ahj.2008.08.026