Prognostic Accuracy of the GRACE Score in Octogenarians and Nonagenarians with Acute Coronary Syndromes
Abstract Background: The GRACE Score was derived and validated from a cohort in which octogenarians and nonagenarians were poorly represented. Objective: To test the accuracy of the GRACE score in predicting in-hospital mortality of very elderly individuals with acute coronary syndromes (ACS). Me...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Sociedade Brasileira de Cardiologia (SBC)
2018-02-01
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| Series: | Arquivos Brasileiros de Cardiologia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2018005001101&lng=en&tlng=en |
| _version_ | 1817981015452286976 |
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| author | Antonio Mauricio dos Santos Cerqueira Junior Luisa Gondim dos Santos Pereira Thiago Menezes Barbosa de Souza Vitor Calixto de Almeida Correia Felipe Kalil Beirão Alexandre Gabriella Sant’Ana Sodré Jessica Gonzalez Suerdieck Felipe Ferreira Marcia Maria Noya Rabelo Luis Cláudio Lemos Correia |
| author_facet | Antonio Mauricio dos Santos Cerqueira Junior Luisa Gondim dos Santos Pereira Thiago Menezes Barbosa de Souza Vitor Calixto de Almeida Correia Felipe Kalil Beirão Alexandre Gabriella Sant’Ana Sodré Jessica Gonzalez Suerdieck Felipe Ferreira Marcia Maria Noya Rabelo Luis Cláudio Lemos Correia |
| author_sort | Antonio Mauricio dos Santos Cerqueira Junior |
| collection | DOAJ |
| description | Abstract Background: The GRACE Score was derived and validated from a cohort in which octogenarians and nonagenarians were poorly represented. Objective: To test the accuracy of the GRACE score in predicting in-hospital mortality of very elderly individuals with acute coronary syndromes (ACS). Methods: Prospective observational study conducted in the intensive coronary care unit of a tertiary center from September 2011 to August 2016. Patients consecutively admitted due to ACS were selected, and the very elderly group was defined by age ≥ 80 years. The GRACE Score was based on admission data and its accuracy was tested regarding prediction of in-hospital death. Statistical significance was defined by p value < 0,05. Results: A total of 994 individuals was studied, 57% male, 77% with non-ST elevation myocardial infarction and 173 (17%) very elderly patients. The mean age of the sample was 65 ± 13 years, and the mean age of very elderly patients subgroup was 85 ± 3.7 years. The C-statistics of the GRACE Score in very elderly patients was 0.86 (95% CI = 0.78 - 0.93), with no difference when compared to the value for younger individuals 0.83 (95% CI = 0.75 - 0.91), with p = 0.69. The calibration of the score in very elderly patients was described by χ2 test of Hosmer-Lemeshow = 2.2 (p = 0.98), while the remaining patients presented χ2 = 9.0 (p = 0.35). Logistic regression analysis for death prediction did not show interaction between GRACE Score and variable of very elderly patients (p = 0.25). Conclusion: The GRACE Score in very elderly patients is accurate in predicting in-hospital ACS mortality, similarly to younger patients. |
| first_indexed | 2024-04-13T23:00:22Z |
| format | Article |
| id | doaj.art-123f0895dc894dca96ad8c6cdf6f9076 |
| institution | Directory Open Access Journal |
| issn | 1678-4170 |
| language | English |
| last_indexed | 2024-04-13T23:00:22Z |
| publishDate | 2018-02-01 |
| publisher | Sociedade Brasileira de Cardiologia (SBC) |
| record_format | Article |
| series | Arquivos Brasileiros de Cardiologia |
| spelling | doaj.art-123f0895dc894dca96ad8c6cdf6f90762022-12-22T02:25:51ZengSociedade Brasileira de Cardiologia (SBC)Arquivos Brasileiros de Cardiologia1678-41702018-02-01010.5935/abc.20170175S0066-782X2018005001101Prognostic Accuracy of the GRACE Score in Octogenarians and Nonagenarians with Acute Coronary SyndromesAntonio Mauricio dos Santos Cerqueira JuniorLuisa Gondim dos Santos PereiraThiago Menezes Barbosa de SouzaVitor Calixto de Almeida CorreiaFelipe Kalil Beirão AlexandreGabriella Sant’Ana SodréJessica Gonzalez SuerdieckFelipe FerreiraMarcia Maria Noya RabeloLuis Cláudio Lemos CorreiaAbstract Background: The GRACE Score was derived and validated from a cohort in which octogenarians and nonagenarians were poorly represented. Objective: To test the accuracy of the GRACE score in predicting in-hospital mortality of very elderly individuals with acute coronary syndromes (ACS). Methods: Prospective observational study conducted in the intensive coronary care unit of a tertiary center from September 2011 to August 2016. Patients consecutively admitted due to ACS were selected, and the very elderly group was defined by age ≥ 80 years. The GRACE Score was based on admission data and its accuracy was tested regarding prediction of in-hospital death. Statistical significance was defined by p value < 0,05. Results: A total of 994 individuals was studied, 57% male, 77% with non-ST elevation myocardial infarction and 173 (17%) very elderly patients. The mean age of the sample was 65 ± 13 years, and the mean age of very elderly patients subgroup was 85 ± 3.7 years. The C-statistics of the GRACE Score in very elderly patients was 0.86 (95% CI = 0.78 - 0.93), with no difference when compared to the value for younger individuals 0.83 (95% CI = 0.75 - 0.91), with p = 0.69. The calibration of the score in very elderly patients was described by χ2 test of Hosmer-Lemeshow = 2.2 (p = 0.98), while the remaining patients presented χ2 = 9.0 (p = 0.35). Logistic regression analysis for death prediction did not show interaction between GRACE Score and variable of very elderly patients (p = 0.25). Conclusion: The GRACE Score in very elderly patients is accurate in predicting in-hospital ACS mortality, similarly to younger patients.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2018005001101&lng=en&tlng=enSíndrome Coronariana Aguda / mortalidadeIdoso de 80 anos ou maisPrognósticoMedição de RiscoConfiabilidade dos Dados |
| spellingShingle | Antonio Mauricio dos Santos Cerqueira Junior Luisa Gondim dos Santos Pereira Thiago Menezes Barbosa de Souza Vitor Calixto de Almeida Correia Felipe Kalil Beirão Alexandre Gabriella Sant’Ana Sodré Jessica Gonzalez Suerdieck Felipe Ferreira Marcia Maria Noya Rabelo Luis Cláudio Lemos Correia Prognostic Accuracy of the GRACE Score in Octogenarians and Nonagenarians with Acute Coronary Syndromes Arquivos Brasileiros de Cardiologia Síndrome Coronariana Aguda / mortalidade Idoso de 80 anos ou mais Prognóstico Medição de Risco Confiabilidade dos Dados |
| title | Prognostic Accuracy of the GRACE Score in Octogenarians and Nonagenarians with Acute Coronary Syndromes |
| title_full | Prognostic Accuracy of the GRACE Score in Octogenarians and Nonagenarians with Acute Coronary Syndromes |
| title_fullStr | Prognostic Accuracy of the GRACE Score in Octogenarians and Nonagenarians with Acute Coronary Syndromes |
| title_full_unstemmed | Prognostic Accuracy of the GRACE Score in Octogenarians and Nonagenarians with Acute Coronary Syndromes |
| title_short | Prognostic Accuracy of the GRACE Score in Octogenarians and Nonagenarians with Acute Coronary Syndromes |
| title_sort | prognostic accuracy of the grace score in octogenarians and nonagenarians with acute coronary syndromes |
| topic | Síndrome Coronariana Aguda / mortalidade Idoso de 80 anos ou mais Prognóstico Medição de Risco Confiabilidade dos Dados |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2018005001101&lng=en&tlng=en |
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