Modeling and Risk Prediction in the Current Era
Modeling and Risk Prediction in the Current Era
In this review article, we evaluated the recent risk score models available for mortality and complication prediction in patients undergoing percutaneous coronary interventions. We reviewed New York State,American College of Cardiology-National Cardiovascular Data Registry, Northern New England Cooperative Group, Cleveland Clinic Foundation, University of Michigan, and Mayo Clinic risk score models.We compared the strengths and weaknesses of each score and then determined the applicability of these scores.At the end, with the help of a few illustrative cases, we explain the application and comparison of risk scores.
With increasing operator experience, refinement in technology, and the availability of improved stent designs, percutaneous coronary intervention (PCI) is now considered the treatment of choice for many high-risk subgroups in whom it was previously contraindicated. The current procedural success rates are high with low attendant periprocedural complications. Assessment of the outcome during PCI is important for having informed discussions with the patient and the families as various treatment options are considered. Outcome analysis is an important tool for quality control, however, benchmarking outcome data are complicated by variations in the case mix, referral patterns, procedural techniques, operator, and hospital volume. Several multivariate models have been published for the prediction of complications following PCI. With the availability of these models, it becomes important for the clinician taking care of a patient undergoing PCI to become familiar with these risk scores and apply them in clinical practice.
In this review article, we evaluated the recent risk score models available for mortality and complication prediction in patients undergoing percutaneous coronary interventions. We reviewed New York State,American College of Cardiology-National Cardiovascular Data Registry, Northern New England Cooperative Group, Cleveland Clinic Foundation, University of Michigan, and Mayo Clinic risk score models.We compared the strengths and weaknesses of each score and then determined the applicability of these scores.At the end, with the help of a few illustrative cases, we explain the application and comparison of risk scores.
With increasing operator experience, refinement in technology, and the availability of improved stent designs, percutaneous coronary intervention (PCI) is now considered the treatment of choice for many high-risk subgroups in whom it was previously contraindicated. The current procedural success rates are high with low attendant periprocedural complications. Assessment of the outcome during PCI is important for having informed discussions with the patient and the families as various treatment options are considered. Outcome analysis is an important tool for quality control, however, benchmarking outcome data are complicated by variations in the case mix, referral patterns, procedural techniques, operator, and hospital volume. Several multivariate models have been published for the prediction of complications following PCI. With the availability of these models, it becomes important for the clinician taking care of a patient undergoing PCI to become familiar with these risk scores and apply them in clinical practice.
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