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European Heart Journal 1981 2(5):395-400;
Copyright © 1981 by the European Society of Cardiology.
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© 1981, by The European Society Of Cardiology

Safe selection of coronary patients for early discharge

A. E. EVANS*,, D. MCC. BOYLE*, J. M. BARBER*, E. L. MCILMOYLE*, M. J. WALSH*,{dagger}, N. C. CHATURVEDI*,{ddagger}, G. MACKENZIE§ and J.H. ELWOODS§

*Coronary Care Unit, Ulster Hospital, Dundonald, Belfast BT 16 0RH
§Department of Community Medicine, The Queens University of Belfast Grosvenor Road, Belfast BT12 6BJ

Received 19 January 1981; revised 4 June 1981; .

Reprints request to: Dr A. E. Evans, Coronary Care Unit, Ulster Hospital, Dundonald, Belfat BT 16 0RH

Abstract

There is a need for the accurate identification of a group of patients with myocardial infarction (MI) who are not going to die in the ensuing three months. These patients should be discharged within four days of their coronary attack. Using data on 298 patients with myocardial infarction a prognostic index (CPI) was derived based on a discriminant function analysis. This index correctly allocated 56.4% of the total into a low risk group (mortality 1.2%) and 43.6% into a high risk group (mortality 36.1%) at three months. The factors were ST segment elevation greater than 2 mm at any time, more than 40 ventricular ectopic beals/h, the presence of R on T ectopics, persistent sinus tachycardia, blood urea above 12 mmol/l. X-ray signs of heart failure and age.

The index was verified prospectively on two groups of consecutive patients and has been successfully used to select patients for discharge on the fourth day

Key Words: Coronary prognostic index • early discharge • arrhythmia • heart failure


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