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A Simple Risk Score to Predict Mortality in Cardiovascular Intensive Care Unit of Sardjito General Hospital Yogyakarta

Author : H.P. Bagaswoto, A. Damarkusuma, N. Taufiq, B.Y. Setianto
Upload Date : 19-04-2018

Background: Cardiovascular Intensive Care Unit (CVCU) remains an area with high mortality rate around the world. Predicting the mortality risk of patients whom hospitalized in CVCU needs a simple tool like scoring systems. Hence, this study aims to analyze the predictors for in?hospital mortality of patients whom hospitalized in CVCU of Sardjito General Hospital Yogyakarta and to create a mortality risk score based on the results of this analysis.

Methods: Data was obtained from SCIENCE (Sardjito Cardiovascular Intensive Care) registry. Outcomes of 595 consecutive patients (mean age 59.92 ± 13.0 yo) from January – November 2017 were recorded retrospectively. Demography, risk factor, comorbidities, laboratorium and other examinations were analyzed by multivariate logistic regression to create 2 model of scoring system (probability and cut-off model) to predict in-hospital mortality of any caused (MACE).

Result: A total of 595 subjects, MACE was found in 54 patients (9.1%). Multiple logistic regression analysis showed some variables that became independent predictor of MACE, i.e. age ≥ 60 yo (OR 1.97), the presence of pneumonia (OR 2.5), use of ventilator machine (OR 21.34), increased of serum glutamate-pyruvate transaminase value (OR 2.18), increased of creatinine value (OR 2.968) and reduced ejection fraction < 40% (OR 2.21). Then, based on ROC curve analysis, cut-off model scoring system with score 3 to 9 predicts MACE compared to score 0-2. This model yields sensitivity 80% and specificity 70%. Meanwhile based on probability scoring system (score 0 to 9), we found the higher the score, the higher the probability of MACE (e.g. the mortality of patient with score 2 is 5.27%; while the mortality of patient with score 8 is 87.5%).

Conclusion: Scoring system derived from this study can be used to predict the in-hospital mortality of patients whom hospitalized in our CVCU with satisfactory sensitivity and specificity value.

KEYWORDS : scoring system, in-hospital mortality, CVCU patients

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