Abstract

GARCIA, Ángel A; MUNOZ, Óscar M; URREA, Juan K  and  BURBANO, Paula X. Validation of the CRUSADE scale to assess the risk of bleeding in patients with acute myocardial infarction without ST elevation. Rev. Colomb. Cardiol. [online]. 2015, vol.22, n.4, pp.169-178. ISSN 0120-5633.  https://doi.org/10.1016/j.rccar.2015.02.008.

Objective: To assess whether CRUSADE scale is applicable in the Colombian community. Methods: A study of external validation in a historical cohort, which included patients hospitalized between 2006 and 2012 in the Hospital Universitario San Ignacio in Bogota Colombia, was performed. Medical records of patients older than 18 years, who had been diagnosed as acute myocardial infarction without ST segment elevation, were included. The number of events (bleeding) predicted and observed during hospitalization (calibration) were compared. Finally, the ability to separate subjects at high and low risk (discrimination) was estimated. Results:252 patients were included. The number of major events was 30 (11.9%) and that of minor events 23 (9.12%); 12 patients (7.46%) died. In the group of very high risk (more than 50 points on the scale), the largest number of events (regarding the study population) was reported. At assessing the scale, a good calibration capacity was evidenced (X² p = .84); however, discrimination was not adequate (0.6128 AUC {95% CI 0.46 to 0.76}). Conclusions Few events were found, although the data suggest that the scale slightly underestimates the risks. The scale has good calibration, but lacks adequate discriminatory capacity, probably due to the fact that a small number of events with high standard deviations were obtained. Therefore, further studies with greater statistical power are required.

Keywords : Acute coronary syndrome without ST elevation; Hemorrhage; Epidemiology.

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