A CORONARY PROGNOSTIC INDEX FOR GRADING THE SEVERITY OF INFARCTION

Open Access
Publisher Website
Google Scholar
Abstract
Factors assessed are age, sex, previous history, shock, cardiac failure, cardiac rhythm, and the nature of the cardiographic changes. The total of the marks awarded for each factor forms the "prognostic index" which may lie anywhere between 1 and 28. The reports regarding each of these factors as a prognostic sign are reviewed and the method that has been used to determine the appropriate weighting for each factor is described. The use of the prognostic index for comparing different series of cases is illustrated by reference to series from 1946-50, 1951-57, and 1958-61. Its use for assessing the value of a particular form of treatment is described in relation to anticoagulant treatment In an individual case, an index between 1 and 8 is associated with an expected mortality of 1 1/2 to 5%, and one between 9 and 12 with a mortality of 10 to 15%. An index from 13 to 16 carries an expected mortality between 22 and 30% and involves an increased risk of cardiac failure in the few months following the attack. An index of 17 or more indicates an extremely grave attack with an average mortality of 65% and a high incidence of cardiac failure following the attack in those who do survive the first months. When the index exceeds 20, the odds against survival are four to one. In patients who have survived the acute stage of the illness the index assessed in the early stage gives a good indication of the average survival time.