Evaluation of prognosis one year after myocardial infarction. 1983

E B Madsen, and E Gilpin, and H Henning

Three multivariate methods for predicting death within 1 year for patients discharged after acute myocardial infarction were evaluated: Cox model, discriminant function analysis and recursive partitioning. Discriminant function analysis was utilized to predict a new myocardial infarction (any new or nonfatal infarction). A Cox classification model developed in a population of 260 patients (group 1) discharged after myocardial infarction was tested in 886 patients from the same institution (group 2) and 582 patients from another institution (group 3). Discriminant function analysis and recursive partitioning were developed in group 2 and tested in group 3. Data gathered during the entire period of hospitalization were utilized. The important variables (ordered as selected by the analyses) for the end point death were: heart failure, ventricular tachycardia and atrioventricular block in the Cox model and heart failure, previous myocardial infarction, age and ventricular premature beats in the discriminant function analysis. For the end point new myocardial infarction, the important variables were: previous myocardial infarction, heart failure, extension of infarction during the acute phase and infarct site. For predicting death and survival within 1 year, each of the three schemes was comparable. For estimating the actual risk of death, the Cox model was best. Recursive partitioning had the advantage of using only one variable--heart failure. Total correct classification ranged from 65.4 (Cox model) to 71.6% (discriminant function analysis) for the original population (groups 1 and 2) and from 47.9 (discriminant function analysis) to 54.3% (recursive partioning) when the schemes were tested in patients in group 3. The Cox model and discriminant function analysis were able to correctly predict over half of the new infarctions within 1 year.

UI MeSH Term Description Entries
D008134 Long-Term Care Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care. Care, Long-Term,Long Term Care
D009203 Myocardial Infarction NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION). Cardiovascular Stroke,Heart Attack,Myocardial Infarct,Cardiovascular Strokes,Heart Attacks,Infarct, Myocardial,Infarction, Myocardial,Infarctions, Myocardial,Infarcts, Myocardial,Myocardial Infarctions,Myocardial Infarcts,Stroke, Cardiovascular,Strokes, Cardiovascular
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D001955 British Columbia A province of Canada on the Pacific coast. Its capital is Victoria. The name given in 1858 derives from the Columbia River which was named by the American captain Robert Gray for his ship Columbia which in turn was named for Columbus. (From Webster's New Geographical Dictionary, 1988, p178 & Room, Brewer's Dictionary of Names, 1992, p81-2)
D003718 Denmark A country in northern Europe, bordering the Baltic Sea and the North Sea. The capital is Copenhagen. Faeroe Islands,Faroe Islands
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006333 Heart Failure A heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. Heart failure can be caused by structural defects, functional abnormalities (VENTRICULAR DYSFUNCTION), or a sudden overload beyond its capacity. Chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as MYOCARDIAL INFARCTION. Cardiac Failure,Heart Decompensation,Congestive Heart Failure,Heart Failure, Congestive,Heart Failure, Left-Sided,Heart Failure, Right-Sided,Left-Sided Heart Failure,Myocardial Failure,Right-Sided Heart Failure,Decompensation, Heart,Heart Failure, Left Sided,Heart Failure, Right Sided,Left Sided Heart Failure,Right Sided Heart Failure
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000704 Analysis of Variance A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable. ANOVA,Analysis, Variance,Variance Analysis,Analyses, Variance,Variance Analyses
D012306 Risk The probability that an event will occur. It encompasses a variety of measures of the probability of a generally unfavorable outcome. Relative Risk,Relative Risks,Risk, Relative,Risks,Risks, Relative

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