First 24-h Sardjito Cardiovascular Intensive Care (SCIENCE) admission risk score to predict mortality in cardiovascular intensive care unit (CICU)

Background and objectives: The application of prognostic scoring systems to identify risk of death within 24 h of CICU admission has significant consequences for clinical decision-making. Previous score of parameters collected after 24 h was considered too late to predict mortality. As a result, we...

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Bibliographic Details
Main Authors: Bagaswoto, Hendry Purnasidha, Ardelia, Yuwinda Prima, Setianto, Budi Yuli
Format: Article
Language:English
Published: Cardiology Society of India 2022
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Online Access:https://repository.ugm.ac.id/284215/1/Bagaswoto_KKMK.pdf
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Summary:Background and objectives: The application of prognostic scoring systems to identify risk of death within 24 h of CICU admission has significant consequences for clinical decision-making. Previous score of parameters collected after 24 h was considered too late to predict mortality. As a result, we attempted to develop a CICU admission risk score to predict hospital mortality using indicators collected within 24 h. Methods: Data were obtained from SCIENCE registry from January 1, 2021 to December 21, 2021. Outcomes of 657 patients (mean age 58.91 ± 12.8 years) were recorded retrospectively. Demography, risk factors, comorbidities, vital signs, laboratory and echocardiography data at 24-h of patient admitted to CICU were analysed by multivariate logistic regression to create two models of scoring system (probability and cut-off model) to predict in-hospital mortality of any cause. Results: From a total of 657 patients, the hospital mortality was 15%. The significant predictors of mortality were male, acute heart failure, hemodynamic instability, pneumonia, baseline creatinine ≥1.5 mg/dL, TAPSE <17 mm, and the use of mechanical ventilator within first 24-h of CICU admission. Based on Receiver Operating Characteristic (ROC) curve analysis a cut off of>3 is considered to be a high risk of inhospital mortality (sensitivity 75% and specificity 65%). Conclusion: The initial 24-h SCIENCE admission risk rating system can be used to predict in-hospital mortality in patients admitted to the CICU with a high degree of sensitivity and specificity.