British Heart Journal, I975, 37, 593-597. Assessment of 3-year prognosis in survivors of acute myocardial infarction

A 3-year follow-up with regard to survival was made of 475 initial survivors of an acute myocardial infarc-tion originally treated in a coronary care unit. Previous diseases, complications during the hospital stay, as well as findings recorded on discharge from hospital, were used to construct a prognostic stratification. By multivariate analyses maximum respiratory rate during the coronary care unit stay, left bundle-branch block, and age proved prognostically most important. Using only thesefactors, patient groups with a 3-year mortality up to 74 per cent were characterized. The problem of evaluating prognosis is an important aspect of clinical medicine. In spite of the introduc-tion of the coronary care unit the prognosis in hos-pital of patients with acute myocardial infarction is both dubious and difficult to foretell in the indi-vidual case. The difficulties of the long-term prog-nosis are no less though many studies have been concentrated on the prognostic implications of different clinical factors. As prognostic stratifica-tion is necessary as a basis for therapeutic trials some long-term prognostic indices and risk profiles have been published (Peel et al., I962; Norris et al., 1970; Oxman et al., 1972; Vedin, 1974). To be of practical value such indices must be easy to apply and preferably include only a few factors which are objective. The present study is a continuation of a previous one which dealt with, mainly, the two-year prognosis in patients surviving an acute myocardial infarct (Helmers, I973). Patients and methods From I968 to I970, 475 patients with acute myocardial infarction were initially treated in the coronary care unit at Serafimerlasarettet and discharged alive. A de-scription of the unit, criteria for admission and diagnosis, as well as definitions of different complications have been published (Biorck et al., I969; Helmers, 1973). Relevant symptoms, physical findings, laboratory data, and complications in the coronary care unit as well as the remainder of the hospital period were recorded by code on special charts and transferred to punch cards. A three-year follow-up with regard to survival was mad