Validity of Simple Risk Index and Evaluation of Methods and Management of Acute Coronary Events to Predict Mortality in Acute Coronary Syndrome Patients in Intensive Coronary Care Unit Cipto Mangunkusumo Hospital
Introduction. Risk stratification is an important part in the management of patients with an Acute Coronary Syndrome (ACS) to avoid overtreatment or undertreatment. Although Simple Risk Index (SRI) and Evaluation of Methods and Management of Acute Coronary Events (EMMACE) have been validated in othe...
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Department of Internal Medicine, Faculty of Medicine Universitas Indonesia-Cipto Mangunkusumo Hospital
2017-12-01
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doaj-8959a3c392f54bf4959068910e8fa8182020-11-25T01:02:32ZindDepartment of Internal Medicine, Faculty of Medicine Universitas Indonesia-Cipto Mangunkusumo HospitalJurnal Penyakit Dalam Indonesia2406-89692549-06212017-12-0144178187http://dx.doi.org/10.7454/jpdi.v4i4.146Validity of Simple Risk Index and Evaluation of Methods and Management of Acute Coronary Events to Predict Mortality in Acute Coronary Syndrome Patients in Intensive Coronary Care Unit Cipto Mangunkusumo HospitalRahmah Safitri Meutia0Sally Aman Nasution1Lukman H Makmun2Esthika Dewiasty3Departemen Ilmu Penyakit Dalam, FKUI-RSCM Indonesia Divisi Kardiologi, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia/RS dr. Cipto Mangunkusumo, Jakarta Indonesia Divisi Kardiologi, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia/RS dr. Cipto Mangunkusumo, Jakarta Indonesia Unit Epidemiologi, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia/RS dr. Cipto Mangunkusumo, Jakarta Indonesia Introduction. Risk stratification is an important part in the management of patients with an Acute Coronary Syndrome (ACS) to avoid overtreatment or undertreatment. Although Simple Risk Index (SRI) and Evaluation of Methods and Management of Acute Coronary Events (EMMACE) have been validated in other countries, no study of its applicability has been performed in Indonesia with different patients’ characteristics. This study aims to obtain the calibration and discrimination performance of SRI and EMMACE to predict 30 days mortality in ACS patients in ICCU of Cipto Mangunkusumo Hospital. Methods. A retrospective cohort study with consecutive sampling was conducted in ACS patients hospitalized in the ICCU Cipto Mangunkusumo hospital between the period of 2003 up to 2010. Data analyzed performed by SPPS program for Windows Version 17. The discrimination performance was explained using a value of area under the receiver-operator curve (AUC) while calibration performance was evaluated using hosmer lemeshow and plot calibration. Results. A total of 922 patients were included in this study consisted of 453 STEMI patients, 234 NSTEMI patients and 235 UAP patients. Simple Risk Index (SRI) score for STEMI had presentable discrimination and calibration performance (AUC= 0,92; R2= 0,98; and p value= 0,01). Simple Risk Index (SRI) score for overall ACS also showed sufficient performance and calibration discrimination (AUC= 0,87; R2= 0,99; and p value= 0,52). Meanwhile, EMMACE score in ACS patients showed satisfactory performance discrimination (AUC= 0,87), but the calibration perfomance was not as satisfactory as the SRI score with the calibration plot (R2)= 0,54 (p value= 0,52). Conclusions. Simple Risk Index (SRI) score shows a satisfactory discrimination and calibration performance both in STEMI and overall ACS patients in predicting mortality of ACS patients in ICCU Cipto Mangunkusumo Hospital. Evaluation of Methods and Management of Acute Coronary Events (EMMACE) score, nonetheless, displays sufficient discrimination performance, but poor performance of calibration.http://jurnalpenyakitdalam.ui.ac.id/index.php/jpdi/article/view/146/130ACSEMMACEmortalityscoreSRIvalidation |
collection |
DOAJ |
language |
Indonesian |
format |
Article |
sources |
DOAJ |
author |
Rahmah Safitri Meutia Sally Aman Nasution Lukman H Makmun Esthika Dewiasty |
spellingShingle |
Rahmah Safitri Meutia Sally Aman Nasution Lukman H Makmun Esthika Dewiasty Validity of Simple Risk Index and Evaluation of Methods and Management of Acute Coronary Events to Predict Mortality in Acute Coronary Syndrome Patients in Intensive Coronary Care Unit Cipto Mangunkusumo Hospital Jurnal Penyakit Dalam Indonesia ACS EMMACE mortality score SRI validation |
author_facet |
Rahmah Safitri Meutia Sally Aman Nasution Lukman H Makmun Esthika Dewiasty |
author_sort |
Rahmah Safitri Meutia |
title |
Validity of Simple Risk Index and Evaluation of Methods and Management of Acute Coronary Events to Predict Mortality in Acute Coronary Syndrome Patients in Intensive Coronary Care Unit Cipto Mangunkusumo Hospital |
title_short |
Validity of Simple Risk Index and Evaluation of Methods and Management of Acute Coronary Events to Predict Mortality in Acute Coronary Syndrome Patients in Intensive Coronary Care Unit Cipto Mangunkusumo Hospital |
title_full |
Validity of Simple Risk Index and Evaluation of Methods and Management of Acute Coronary Events to Predict Mortality in Acute Coronary Syndrome Patients in Intensive Coronary Care Unit Cipto Mangunkusumo Hospital |
title_fullStr |
Validity of Simple Risk Index and Evaluation of Methods and Management of Acute Coronary Events to Predict Mortality in Acute Coronary Syndrome Patients in Intensive Coronary Care Unit Cipto Mangunkusumo Hospital |
title_full_unstemmed |
Validity of Simple Risk Index and Evaluation of Methods and Management of Acute Coronary Events to Predict Mortality in Acute Coronary Syndrome Patients in Intensive Coronary Care Unit Cipto Mangunkusumo Hospital |
title_sort |
validity of simple risk index and evaluation of methods and management of acute coronary events to predict mortality in acute coronary syndrome patients in intensive coronary care unit cipto mangunkusumo hospital |
publisher |
Department of Internal Medicine, Faculty of Medicine Universitas Indonesia-Cipto Mangunkusumo Hospital |
series |
Jurnal Penyakit Dalam Indonesia |
issn |
2406-8969 2549-0621 |
publishDate |
2017-12-01 |
description |
Introduction. Risk stratification is an important part in the management of patients with an Acute Coronary Syndrome (ACS) to avoid overtreatment or undertreatment. Although Simple Risk Index (SRI) and Evaluation of Methods and Management of Acute Coronary Events (EMMACE) have been validated in other countries, no study of its applicability has been performed in Indonesia with different patients’ characteristics. This study aims to obtain the calibration and discrimination performance of SRI and EMMACE to predict 30 days mortality in ACS patients in ICCU of Cipto Mangunkusumo Hospital.
Methods. A retrospective cohort study with consecutive sampling was conducted in ACS patients hospitalized in the ICCU Cipto Mangunkusumo hospital between the period of 2003 up to 2010. Data analyzed performed by SPPS program for Windows Version 17. The discrimination performance was explained using a value of area under the receiver-operator curve (AUC) while calibration performance was evaluated using hosmer lemeshow and plot calibration.
Results. A total of 922 patients were included in this study consisted of 453 STEMI patients, 234 NSTEMI patients and 235 UAP patients. Simple Risk Index (SRI) score for STEMI had presentable discrimination and calibration performance (AUC= 0,92; R2= 0,98; and p value= 0,01). Simple Risk Index (SRI) score for overall ACS also showed sufficient performance and calibration discrimination (AUC= 0,87; R2= 0,99; and p value= 0,52). Meanwhile, EMMACE score in ACS patients showed satisfactory performance discrimination (AUC= 0,87), but the calibration perfomance was not as satisfactory as the SRI score with the calibration plot (R2)= 0,54 (p value= 0,52).
Conclusions. Simple Risk Index (SRI) score shows a satisfactory discrimination and calibration performance both in STEMI and overall ACS patients in predicting mortality of ACS patients in ICCU Cipto Mangunkusumo Hospital. Evaluation of Methods and Management of Acute Coronary Events (EMMACE) score, nonetheless, displays sufficient discrimination performance, but poor performance of calibration. |
topic |
ACS EMMACE mortality score SRI validation |
url |
http://jurnalpenyakitdalam.ui.ac.id/index.php/jpdi/article/view/146/130 |
work_keys_str_mv |
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