摘要
Background: Patients with advanced heart disease are at risk from sudden death; however, benefit from implantable cardioverter defibrillators(ICDs) may be limited as a result of early mortality from other causes. The objective of this study was to develop a model to predict mortality within the first year after ICD implantation. Methods and Results: A retrospective analysis was performed of 469 consecutive patients who underwent ICD implantation at a single tertiary- care center from 1999 to 2002. Vital status was determined from the Social Security Death Index. Patients were randomized into prediction and validation cohorts. A risk score was derived from the prediction cohort by multivariate logistic regression and applied to the validation cohort. One point was assigned for each variable in the risk score(age>80 years, history of atrial fibrillation, creatinine> 1.8 mg/dL,New York Heart Association class III or IV). One- year mortality significantly increased with increasing risk score in both the prediction and validation cohorts. Validation cohort mortality was 3.4% for 0 points, 4.3% for 1 point, 17% for 2 points, and 33% for ≥ 3 points(P for trend< .0001). A risk score ≥ 2 predicted a 1- year mortality rate of 21% , whereas a risk score< 2 predicted a mortality rate of 4% at 1 year(P< .0001). Conclusion: A risk score using simple clinical criteria may identify patients at high risk of early mortality after ICD implantation. This may be helpful in consideration of ICD risk/benefit for individual patients. Further studies conducted in a prospective manner using these clinical criteria are warranted.
Background： Patients with advanced heart disease are at risk from sudden death; however, benefit from implantable cardioverter defibrillators（ICDs） may be limited as a result of early mortality from other causes. The objective of this study was to develop a model to predict mortality within the first year after ICD implantation. Methods and Results： A was performed of 469 consecutive patients who underwent ICD implantation at a single tertiary-care center from 1999 to 2002. Vital status was determined from the Social Security Death Index. Patients were randomized into prediction and validation cohorts. A risk score was derived from the prediction cohort by multivariate logistic regression and applied to the validation cohort. One point was assigned for each variable in the risk score（age〉 80 years, history of atrial fibrillation,
