Prediction of death after percutaneous coronary interventional procedures

Background The prediction and comparison of procedural death oiler percutan eous coronary interventional procedures is inherently difficult because of variations in case mix and practice patterns. The impact of modern, expande d patient selection criteria, and newer technologic approaches is unknown. Our objective was to determine whether a risk equation bored on patient-rel ated variables and derived from an independent data set can accurately pred ict procedural death after percutaneous coronary intervention in the curren t era. Methods and Results An analysis was made of the Mayo Clinic Coronary Interv entional Database January 1, 1995, to October 31, 1997. Expected mortality rate was calculated with the use of the New York State multivariate risk sc ore. In 3387 patients. 3830 procedures (55.1% stents) were performed, with an expected mortality rate ai 2.32% and observed mortality rate of 2.38% (P = not significant). The risk score derived from the New York multivariate model was highly predictive of death (chi-square = 213.8; P < .0001). The p resence of a high-risk lesion characteristic such as calcium, thrombus, or type C lesion was modestly associated with death. Conclusions The New York State multivariate model accurately predicted proc edural death in our database.