Journal of Clinical Epidemiology
Volume 56, Issue 1 , Pages 17-27, January 2003

Major adverse outcomes after percutaneous transluminal coronary angioplasty:

a clinical prediction rule

  • Elizabeth B Fortescue

      Affiliations

    • Division of General Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Neville House Room 341, 75 Francis Street, Boston, MA 02115, USA
    • ,
  • Katherine Kahn

      Affiliations

    • Divisions of General Internal Medicine and Health Services Research, UCLA Medical Center, B-976 Factor Building, 10833 La Comte Ave., Los Angeles, CA, 90095-173 USA
    • ,
  • David W Bates

      Affiliations

    • Corresponding Author InformationCorresponding author. Tel.: 617- 732-7063; fax: 617-732-7072.
    • Division of General Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Neville House Room 341, 75 Francis Street, Boston, MA 02115, USA

Received 29 October 2001; received in revised form 4 June 2002; accepted 5 September 2002.

Abstract 

In this study, we developed and internally validated a clinical model for predicting major adverse outcomes in patients undergoing percutaneous transluminal coronary angioplasty (PTCA) using a multi-institutional prospective cohort study involving all adult patients who underwent PTCA at 12 participating institutions from August 1993 to October 1995. A major adverse outcome, defined as death, renal failure, myocardial infarction, cardiac arrest, stroke, or coma, occurred in 3.3 and 3.2% of patients in the derivation and validation sets, respectively. Death occurred in 1.5% in both sets. Fourteen variables were independently correlated with major adverse outcomes. The rule, which stratifies PTCA patients into six levels of risk based on the severity score, showed excellent discrimination (receiver-operating characteristic curve area 0.82) and calibration (Hosmer-Lemeshow chi-square statistic P = .90) and performed well on internal validation. This rule allows accurate preprocedure stratification of PTCA candidates according to their risk of suffering a major adverse outcome.

Keywords:  Quality, Percutaneous transluminal coronary angioplasty, Major adverse outcomes

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PII: S0895-4356(02)00538-3

Journal of Clinical Epidemiology
Volume 56, Issue 1 , Pages 17-27, January 2003

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