Predictors of In-Hospital Mortality Among Acute Myocardial Infarction Patients in a Large Health Care System

Zhang, Huiling. Predictors of In-hospital Mortality Among Acute Myocardial Infarction Patients in a Large Health Care System. Master of Public Health, July 2000, 29 pp., 4 tables, 29 references. Background---There is increasing interest in the identification of risk predictors for in-hospital mortality due to acute myocardial infarction (AMI). To date, there has been no AMI in-hospital mortality prediction models developed using clinical database. Methods and Results---The study population consists of 4,167 AMI cases admitted to 36 hospitals in 3 states. Thirty variables were selected as candidate predictors, and 19 showed significant bivariate association with AMI in-hospital mortality. By applying multiple logistic regression and stepwise selection, 10 variables were selected for inclusion in the final prediction model: age, arrive from cardiac rehabilitation center, CPR on arrival, Killip class, AMI with comorbidities, AMI with complications, PCTA performed, beta-blockers given, ACE inhibitors given, Plavix given. Conclusion---A ten-variable in-hospital mortality prediction model for AMI patients, which includes both risk factors and beneficial treatment procedures, was developed. Chi-square goodness of fit test suggested a very good fit for the model.