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- W2485346422 abstract "Background: Bleeding is a common complication of acute myocardial infarction (AMI) management and is associated with worse outcomes. Risk estimation is important to guide choice and intensity of therapy and minimize bleeding-related adverse events. Methods: Using AR-G data, an in-hospital major bleeding model and risk score was developed. Major bleeding was defined as a HCT drop >12%, ICH, retroperitoneal bleeding or transfusion if baseline HCT >28%, and transfusion if baseline HCT <28% with witnessed bleeding. The model used only baseline variables and was developed (n=72,313) and validated (n=17,960) in STEMI and NSTEMI patients (251 US centers from 1/07 to 12/08). C statistic was tested in the derivation and validation cohorts and across key subgroups. Results: Twelve independent factors were identified: heart rate, baseline hemoglobin, female sex, initial creatinine, older age, EKG changes, heart failure or shock on presentation, diabetes, peripheral artery disease, lower weight, systolic blood pressure, and home warfarin use. The model discriminated in the derivation (c=0.73) and validation (c=0.71) cohorts. A score (0-91) was created for the relative odds for major bleeding. Bleeding risk increased tenfold from lowest to highest score: very low risk (3.9%), low risk (7.3%), moderate risk (16.1%), high risk (29%), and very high risk (40%). This trend was consistent across age, sex, and MI type (Figure). Conclusion: The AR-G bleeding model and score estimates bleeding risk across a broad range of STEMI and NSTEMI patients. The model provides clinicians an easy-to-use aid to facilitate treatment decision making and may ultimately promote better patient outcomes." @default.
- W2485346422 created "2016-08-23" @default.
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- W2485346422 date "2011-11-01" @default.
- W2485346422 modified "2023-09-27" @default.
- W2485346422 title "Abstract P337: Prediction of In-Hospital Major Bleeding Among Patients With Acute Myocardial Infarction: Results From 90,273 Patients in the Acute Coronary Treatment Intervention Outcomes Network Registry®- Get With the Guidelines™ (AR-G)" @default.
- W2485346422 doi "https://doi.org/10.1161/circoutcomes.4.suppl_1.ap337" @default.
- W2485346422 hasPublicationYear "2011" @default.
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