PREDICT: A simple risk score for clinical severity and long-term prognosisafter hospitalization for acute myocardial infarction or unstable angina -The Minnesota Heart Survey

Background-We evaluated short- and long-term mortality risks in 30- to 74-y ear-old patients hospitalized for acute myocardial infarction or unstable a ngina and developed a new score called PREDICT. Methods and Results-PREDICT was based on information routinely collected in hospital. Predictors abstracted from hospital record items pertaining to t he admission day, including shock, heart failure, ECG findings, cardiovascu lar disease history, kidney function, and age. Comorbidity was assessed fro m discharge diagnoses, and mortality was determined from death certificates . For 1985 and 1990 hospitalizations, the 6-year death rate in 6134 patient s with 0 to 1 score points was 4%, increasing stepwise to 89% for greater t han or equal to 16 points. Score validity was established by only slightly attenuated mortality prediction in 3570 admissions in 1970 and 1980. When c ase severity was controlled for, 6-year risk declined 32% between 1970 and 1990. When PREDICT was held constant, 24% of those treated with thrombolysi s died in 6 years compared with 31% of those not treated. Conclusions-The simple PREDICT risk score was a powerful prognosticator of B-year mortality after hospitalization.