# The Mayo Clinic Risk Score

The Mayo Clinic Risk Calculator Models for Prediction of In-Hospital Death (PCI and CABG)

### I. PCI Risk of Death:

The coefficients for age, left ventricular ejection fraction (LVEF), and serum creatinine level can be determined from the nomograms at the bottom. Note that congestive heart failure (CHF) needs to be entered only for patients not presenting with myocardial infarction (MI) or shock. If LVEF is unavailable, enter 1 for the LVEF contribution if the patient presents with CHF; enter 0 otherwise. If serum creatinine level is unavailable, enter 1 for the creatinine contribution if the patient is a man presenting with CHF; enter 0 otherwise. The equation for the log odds ratio of procedural death is Log Odds Ratio = -6.535 + [0.342 × score]. AMI = acute MI.

### I. PCI Risk of MACE:

New Mayo Clinic Risk Model for Prediction of Major Adverse Cardiac Events (MACE). The same variables appear in this model except there is no interaction for the congestive heart failure (CHF) effect. If left ventricular ejection fraction (LVEF) is unavailable, add 1 for the LVEF fraction contribution if the patient presents with CHF; enter 0 otherwise. If serum creatinine level is unavailable, add 1 for the creatinine contribution if the patient is a man, and add 1 if the patient is presenting with CHF; enter 0 if the patient is a woman without CHF. The equation for the log odds ratio of MACE is Log Odds Ratio = -4.450 + [0.228 × score]. MI = myocardial infarction.

### II. CABG:

New Mayo Clinic risk model for prediction of in-hospital death. Coefficients for age, left ventricular ejection fraction (LV EF), and serum creatinine can be determined from the nomograms at the bottom. Note that congestive heart failure (CHF) needs to be entered only for patients not presenting with myocardial infarction (MI) or shock. The equation for log-odds of death is LogOdds=–6.082+0.2883xscore. AMI indicates acute myocardial infarction. For missing values: If creatinine is unavailable, do the following: Add 1 point if patient is male, and 1 point if patient has CHF. If ejection fraction is unavailable, do the following: Add 1 point if patient has CHF. For other variables, if a risk factor is unknown, no points are added.

If you would rather enter data into a form, this is a good link:

http://www.zunis.org/Mayo%20Clinic%20-%20Death%20and%20MACE%20After%20PCI%20-%20Risk%20Calculator%202007.htm

## Comment:

Of all the Risk predictor algorithms this one appears most useful for bedside assessment and prediction. Although designed as a predictor of in-hospital Death for PCI, it also predicts the mortality risk for CABG.