SEARCH · Search PubMed

Results for “Risk score”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources

PubMed2006

Risk scoring in the assessment of cardiovascular risk.

PURPOSE OF REVIEW: Cardiovascular risk scoring is incorporated in guidelines and recommended for targeting preventive treatment. Evidence is required on the most appropriate method, its accuracy in a given population, and its effectiveness in favourably influencing clinical behaviour and health outcomes. RECENT FINDINGS: Recent risk scores address inaccuracies that arise when methods are transferred between populations, and specific methods and recalibrations are described for use in low-risk populations. Ethnic and social differences in risk are also recognized in the context of cardiovascular risk scoring. More sensitive measures of known risk factors and numerous emerging risk factors are reported and new statistical methods and sources of data suggested. Little emphasis has been placed on evaluation of the clinical effectiveness of cardiovascular risk scores. Education in cardiovascular risk assessment may help improve uptake of methods by healthcare professionals. SUMMARY: Numerous risk scoring methods are available to the healthcare professional but use is patchy. Accuracy varies between populations and methods have been developed to compensate for some of this variability. If risk scoring methods are to be widely used in general practice, evidence is required on both the accuracy of methods in appropriate populations and their effectiveness in improving health outcomes.

Age Factors↗

PubMed1993

A review of risk scoring for preterm birth.

Risk scoring is a quantitative method used to screen populations to identify persons at increased risk of developing a specific adverse health outcome. Risk scoring for preterm birth has taken the form of a simple additive score with risk factors based on clinical experience to sophisticated multivariable risk models using a large number of factors from several domains. It appears that our attempts at defining an effective risk scoring method for preterm birth have been unsuccessful. The positive predictive values (the percent of women defined as high risk that actually go on to have a preterm birth) have been relatively low (20% to 30%) and vary depending on the population studied. Several difficulties with risk scoring for preterm birth are identified. The biggest limitation of current efforts at screening for preterm birth is our ignorance of the causes of preterm birth. The role of recently defined risk factors, of the potential for synergistic relationship between risk factors, and of physician or hospital factors needs to be evaluated. Epidemiologic evidence is suggestive that preterm birth can be subclassified into preterm labor, preterm rupture of the membranes, and medically induced preterm births; however, substantial problems with misclassification, detection bias, and questionable biologic feasibility argue that these subgroups need to be validated before they can be used with confidence. Careful attention should also be paid to the statistical and methodologic limitations of risk scoring. Unless a single risk factor for a disease outcome has a relative risk over 5 and is very prevalent in the population (more than 25%), most of the disease cases will not have the risk factor. It may be unrealistic, however, to think that a single risk factor will adequately define women at high risk for preterm birth. Therefore in the future, if several lesser risk factors can be identified, multivariate modeling may prove useful in defining a valid high-risk group. In addition, attention should be paid to ensure that the risk factor assessment tools obtain accurate information and are easily reproducible among different health care providers. The reduction of preterm birth in France that occurred over a decade was accompanied by radical social changes in the ways in which the population and government perceived pregnancy and childbirth. In addition to universal access to prenatal care, population-based social changes to liberalize pregnancy leave policies and a commitment to supporting women during pregnancy were the focus of the government's commitment to reducing preterm birth.(ABSTRACT TRUNCATED AT 400 WORDS)

Discriminant Analysis↗

PubMed2000

Simple pediatric nutritional risk score to identify children at risk of malnutrition.

BACKGROUND: Although hospitalized children are at risk of malnutrition, routine screening of nutritional status has been hindered by lack of a validated nutritional assessment tool. OBJECTIVE: Our aim was to develop a simple pediatric nutritional risk score that could be used at hospital admission to identify patients at risk of acute malnutrition during hospitalization. DESIGN: Nutritional risk was assessed prospectively in 296 children. Anthropometric measurements, food intake, ability to eat and retain food, medical condition, and symptoms interfering with feeding (pain, dyspnea, and depression) were evaluated within 48 h of admission. Pathology was classified as mild (grade 1), moderate (grade 2), or severe (grade 3). The risk of weight loss was investigated with stepwise logistic regression. RESULTS: Weight loss during hospitalization occurred in 65% of the children and was >2% of admission weight in 45% of patients. Multivariate analysis indicated that food intake <50%, pain, and grade 2 and 3 pathologic conditions (P = 0.0001 for all) were associated with weight losses of >2%. The nutritional risk score ranged from 0 to 5 and was calculated by adding the values for the significant risk factors as follows: 1 for food intake <50%, 1 for pain, 1 for grade 2 pathologic condition, and 3 for grade 3 pathologic condition. A score of 1 or 2 indicated moderate risk and a score >/=3 indicated high risk of malnutrition. CONCLUSIONS: This simple score is suitable for routine use to identify patients at risk of malnutrition during hospitalization. Implementation may prevent hospital-acquired malnutrition.

Child↗

PubMedDate not supplied

[Cardiovascular risk percentiles avoid overestimation or underestimation of risk calculated by the SCORE risk function].

BACKGROUND: Cardiovascular risk evaluation is of the utmost importance for treatment of patients with cardiovascular risk factors. There are various scales or equations and they can be adapted to a particular population to try to avoid over or under estimation of risk. We propose risk percentiles as a new method of adapting risk scoring systems to our population. METHODS: A cross sectional study of the prevalence of cardiovascular risk factors in the province of Palencia (ERVPA: Cardiovascular Risk Study in Palencia) was conducted. Age, gender, blood pressure, total cholesterol, tobacco consumption and diabetes were evaluated. 514 subjects aged 20 - 79 taken from the general population were studied in 9 health centers from Palencia (Spain). Fatal cardiovascular risk was measured with SCORE project equations. Percentiles were calculated and compared to both equations and a Spearman's correlation coefficient and a kappa agreement coefficient were calculated. RESULTS: The percentages of high risk range from 0% in young subjects to 92% in males over the age of 70 and 67% in females over the age of 70. The concordance with high risk country equations has a kappa coefficient of 0.741. Concordance varies greatly with age and gender. On comparing the percentiles, the concordance between both equations is almost absolute. CONCLUSIONS: Adopting risk percentiles as a method of cardiovascular risk evaluation permits us to adapt any risk equation to a particular area and avoids underestimation or overestimation of risk. Risk percentiles allow us to extrapolate absolute risk for any age.

Adult↗

PubMed2005

Carotid intima-media thickness, plaques, and Framingham risk score as independent determinants of stroke risk.

BACKGROUND AND PURPOSE: The Framingham stroke risk score (FSRS) and Framingham cardiovascular risk score (FCRS) estimate the individual absolute cardiovascular and stroke risks. Common carotid artery intima-media thickness (CCA-IMT) and carotid plaques (CPs) are markers of subclinical atherosclerosis and help in the early identification of presymptomatic individuals. The purpose of this study was to correlate Framingham risk score (FRS) with CCA-IMT and CPs and evaluate their respective contribution to stroke risk. METHODS: In 510 consecutive patients with brain infarction and 510 matched controls, we calculated the FSRS and FCRS for each individual and performed carotid ultrasonography. Mean CCA-IMT was measured off-line at a central core laboratory, and presence of CPs was assessed. RESULTS: FRS progressively increased according to tertiles of CCA-IMT (P for trend <0.0001). The part of the variances of FSRS and FCRS explained by CCA-IMT was respectively 11% and 20%. The relationships between CCA-IMT and FRS were significantly different between patients with or without CPs (P for interaction <0.005). With increasing CCA-IMT, the 10-year FRS gradually increased between 10% and 20% in the presence of CPs and between 5% and 20% in the absence of CPs. Multiple conditional logistic regression for matched sets showed that CCA-IMT, FCRS, and CPs were independently associated with stroke risk, with an odds ratio of 1.68 (1.25 to 2.26; P=0.0006), 2.16 (1.57 to 2.98; P<0.0001), and 2.73 (1.68 to 4.44; P<0.0001), respectively, meaning that each of them may be important for evaluation of the individual cardiovascular risk. CONCLUSIONS: CCA-IMT, CPs, and FRSs correlated well. The CCA-IMT value may help discriminate between subjects at low or high 10-year risk.

Adult↗

PubMed2025

Associations Between Polygenic Risk Score for Blood Pressure and Risk of Hypertension in Northeast Asian Individuals.

BACKGROUND: Data on associations between genetic predisposition to high blood pressure (BP) and hypertension and its complications in non-European populations are limited. The current study investigated associations between polygenic risk scores (PRSs) for BP and risks of hypertension, cardiovascular disease, and chronic kidney disease in Northeast Asian populations. METHODS: A genome-wide association study of systolic BP (SBP) and diastolic BP (DBP) was conducted using data from the KoGES (Korean Genome and Epidemiology Study). Results were meta-analyzed using summary statistics from Biobank Japan to construct PRSs. RESULTS: Compared with a PRS in the lowest 5 percentiles, a PRS in the highest 5 percentiles was associated with an increased risk of hypertension (hazard ratio [HR], 2.44 [95% CI, 1.67-3.56] for PRS for SBP; and HR, 1.77 [95% CI, 1.20-2.62] for PRS for DBP) and earlier onset of hypertension (by a median of 8.5 years for PRS for SBP and 8.0 years for PRS for DBP). These associations remained significant when continuous PRS was analyzed. The genetic risk of hypertension incidence was attenuated by moderate to vigorous physical activity. Adding the PRS for BP to the clinical risk factors improved the predictive value for hypertension (both area under the curve values, 0.787 [95% CI, 0.771-0.803]; P=0.063 for PRS for SBP and [95% CI, 0.771-0.804]; P=0.031 for PRS for DBP). However, neither PRS for SBP nor PRS for DBP was associated with the incidence of cardiovascular or chronic kidney disease. CONCLUSIONS: The PRS for BP was associated with a higher risk of incident hypertension and earlier-onset hypertension in a Northeast Asian population. PRS may facilitate early identification and targeted management of individuals at high risk of developing hypertension.

Adult↗

PubMed2026

Association between oxidative balance score and cardiovascular risk factors, aging, and incidence of dementia risk score: A prospective cohort study.

BackgroundOxidative stress is a key contributor to the pathogenesis of Alzheimer's disease and other dementias. The oxidative balance score (OBS), which reflects combined dietary and lifestyle exposure to pro-oxidant and antioxidant factors, serves as an integrated measure of oxidative stress burden.ObjectiveTo investigate the association between OBS and predicted late-life dementia risk using the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) score.MethodsWe analyzed data from 5088 participants aged 40-69 years without dementia at baseline from the Korean Genome and Epidemiology Study. Participants were categorized by OBS tertiles. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for developing a high risk of late-life dementia, defined by a CAIDE score ≥8. Longitudinal changes in CAIDE scores were assessed using linear mixed-effects models.ResultsDuring a mean follow-up of 12.8 years, 1468 participants (28.9%) progressed to CAIDE-predicted high risk for late-life dementia. Compared with the lowest OBS tertile (T1), participants in the highest tertile (T3) had a significantly lower risk for developing high-risk late-life dementia (HR 0.74, 95% CI 0.65-0.84) and exhibited the lowest CAIDE scores (p < 0.001). Each one-point increase in the OBS was associated with a 3% reduction in CAIDE-predicted dementia risk.ConclusionsA higher OBS was significantly associated with a lower predicted risk of late-life dementia. These findings suggest that maintaining an antioxidant-rich diet and a healthy lifestyle during midlife may be effective strategies for dementia prevention.

Alzheimer's disease↗

PubMed2004

Concordance evaluation of coronary risk scores: implications for cardiovascular risk screening.

OBJECTIVE: To assess the similarities and differences in predicted high-risk individuals identified by different cardiovascular risk calculation algorithms Research design and methods: A representative population of 10000 individuals was modelled in a computer using baseline data from the National Health Survey for England. The effects of biological groups identified by each calculator depend on the variation in each major model parameters were then applied to each hypothetical individual. The predictive capacities of 3 different risk identification systems based on computer calculation (the Framingham algorithm), or on tabular methods (the Sheffield tables and the General Rule to Enable Atheroma Treatment) were evaluated. RESULTS: All three models predict that similar numbers would receive treatment with 2.9 and 10% receiving treatment at 30 and 15% 10 year risk thresholds, respectively. However, concordance is limited as 0.3 or 6.8% are positive on all three systems; 1.6 or 9.7% on any two calculators at the 30 and 15% thresholds, respectively. The risk baseline assumptions in each model. CONCLUSION: Care needs to be taken with applying risk calculators to populations different from which they were derived. Any cardiovascular risk scoring system needs to be thoroughly evaluated against epidemiological data before it is introduced and also needs to be updated in line with changing trends in risk factors.

Algorithms↗

PubMed2004

The Risk Score Profile: a novel approach to characterising the risk of populations enrolled in clinical studies.

AIMS: Interpreting the results and practice implications of clinical studies requires accurate characterisation of the baseline risk of the population. We evaluated the Thrombolysis in Myocardial Infarction (TIMI) risk score for STEMI as a tool to describe and compare the risk profile of populations enrolled in three clinical trials (InTIME-II, ASSENT-2 and MAGIC) and the National Registry of Myocardial Infarction. METHODS AND RESULTS: The risk score was calculated for each patient (N=121,085) and the frequency distribution plotted for each population. The Risk Score Profiles were compared using the Kolmogorov-Smirnov test. The Risk Score Profile demonstrated a striking concordance between the baseline risk of patients in InTIME-II and ASSENT-2 (median scores in each= 3[1,4], P=0.11). In contrast, the distributions in MAGIC (designed to enroll high risk) and NRMI (registry) were shifted significantly toward higher risk (median scores=4[3,5] for MAGIC and 4[2,6] in NRMI, P < 0.0001 for each vs. InTIME-II). A graded relationship between the risk score and mortality was evident in each study (P<0.0001). CONCLUSIONS: The frequency distribution of the TIMI Risk Score, or similar tools for risk assessment, may be used to quantify and readily compare the risk profile of populations enrolled in clinical studies.

Aged↗

PubMed2026

Harnessing Polygenic Risk Scores to Refine Venous Thromboembolism Risk Stratification.

BACKGROUND: Venous thromboembolism (VTE) is a major cause of morbidity in patients of all ages. Despite growing interest in polygenic risk scores (PRS) for VTE, their utility remains understudied. Our objective was to evaluate the independent impact of a PRS on VTE susceptibility in adults and children. METHODS: We completed a retrospective, case-control study of two separate cohorts with evaluation of three VTE PRS models, with the primary analysis focused on a 293 single nucleotide polymorphism (SNP) PRS. The adult cohort included 597 VTE cases and 31 998 controls, and the pediatric cohort included 109 cases and 448 controls, both obtained from a de-identified databank with linked genetic data. Separate adult and pediatric multivariable logistic regressions were performed to measure the association of risk factors with VTE. RESULTS: Higher PRS in adults was significantly associated with increased odds of VTE, with each 1-standard deviation increase in PRS conferring an adjusted odds ratio of 1.25 (OR = 1.25, 95% CI 1.15-1.36, p < 0.001). Leading risk factors for adults were cancer (OR = 2.43, 95% CI: 2.04-2.89, p < 0.001) and recent surgery (OR = 2.16, 95% CI: 1.83-2.54, p < 0.001). The standardized PRS also exhibited increased risk for VTE in children (OR = 1.38, 95% CI 1.10-1.74, p = 0.003). Central venous catheterization (OR = 5.65, 95% CI 3.40-9.50, p < 0.001) was the foremost risk factor for pediatric VTE. CONCLUSION: VTE in adults and children is multifactorial, with clinical and genome-wide risk factors contributing. PRS may serve as a valuable adjunct to clinical risk factors for VTE risk stratification.

Humans↗

PubMed2025

Integrating Imaging-Derived Clinical Endotypes with Plasma Proteomics and External Polygenic Risk Scores Enhances Coronary Microvascular Disease Risk Prediction.

Coronary microvascular disease (CMVD) is an underdiagnosed but significant contributor to the burden of ischemic heart disease, characterized by angina and myocardial infarction. The development of risk prediction models such as polygenic risk scores (PRS) for CMVD has been limited by a lack of large-scale genome-wide association studies (GWAS). However, there is significant overlap between CMVD and enrollment criteria for coronary artery disease (CAD) GWAS. In this study, we developed CMVD PRS models by selecting variants identified in a CMVD GWAS and applying weights from an external CAD GWAS, using CMVD-associated loci as proxies for the genetic risk. We integrated plasma proteomics, clinical measures from perfusion PET imaging, and PRS to evaluate their contributions to CMVD risk prediction in comprehensive machine and deep learning models. We then developed a novel unsupervised endotyping framework for CMVD from perfusion PET-derived myocardial blood flow data, revealing distinct patient subgroups beyond traditional case-control definitions. This imaging-based stratification substantially improved classification performance alongside plasma proteomics and PRS, achieving AUROCs between 0.65 and 0.73 per class, significantly outperforming binary classifiers and existing clinical models, highlighting the potential of this stratification approach to enable more precise and personalized diagnosis by capturing the underlying heterogeneity of CMVD. This work represents the first application of imaging-based endotyping and the integration of genetic and proteomic data for CMVD risk prediction, establishing a framework for multimodal modeling in complex diseases.

Cardiovascular Disease↗

PubMed2026

Genome-wide association, polygenic risk scores, and machine learning for chronic post-surgical pain risk stratification: A UK biobank study.

Chronic post-surgical pain is a prevalent and debilitating complication following surgery, representing a clinical challenge. Despite the established heritability of pain phenotypes, large-scale genetic studies remain limited. This study aimed to identify genetic variants associated with chronic post-surgical pain, develop polygenic risk scores, and integrate these with clinical features for risk prediction. UK Biobank data from 47,836 participants (2490 cases and 45,346 controls) were split into training (80%; n = 38,268) and validation (20%; n = 9568) sets prior to analysis. A genome-wide association study was conducted on the training set only, across 19 million variants, and polygenic risk scores were constructed and integrated with clinical features in a logistic regression framework. Two close, rare, imputed signals crossed the genome-wide significance threshold but lacked local linkage-disequilibrium support, while 220 variants crossed the suggestive threshold. In the held-out validation set, cases had higher mean polygenic risk scores than controls (0.138 vs. -0.021; Cohen's d = 0.16, p < 0.001). A logistic regression model integrating clinical features and polygenic risk scores achieved an area under the curve of 0.639 (95% CI: 0.583-0.693), higher than models using either feature set alone. The polygenic risk score for chronic post-surgical pain was among the most important predictors. Risk stratification revealed the top quartile had 3.84-fold higher odds of chronic post-surgical pain than the bottom quartile (95% CI: 2.00-7.37). These findings suggest a possible modest genetic contribution to chronic post-surgical pain. Polygenic risk scores may complement clinical factors in surgical risk stratification. PERSPECTIVE: Chronic post-surgical pain may have a modest genetic contribution. This UK Biobank study identified over 220 variants at suggestive significance and constructed a polygenic risk score that was significantly elevated in cases. A combined clinical-genomic model achieved a 3.84-fold difference in odds across predicted-risk quartiles.

Chronic post-surgical pain↗

PubMed1990

On the use of a logistic risk score in predicting risk of coronary heart disease.

Many studies over the last 20 years have used logistic regression to model the relationship between the risk of developing coronary heart disease (CHD) and the levels of risk factors such as high blood pressure, high serum cholesterol, and cigarette smoking. Subsequently, several investigators have proposed the use of some of the published estimated logistic risk functions to predict risk in new populations. Because of great variation in definition of event, duration of follow-up, population characteristics, definition of risk variables, and selection of other variables in the logistic functions, direct use of such established functions would generally not have validity for the prediction of absolute risk levels. A review of fifteen of these studies indicates on the one hand generally similar results in direction and order of magnitude of effects of the major risk factors, confirming the importance of these risk factors of CHD. On the other hand the reviews indicate sufficient variation to suggest that extrapolation to new populations even to predict relative risk is not justified.

Age Factors↗

PubMed1995

The beneficial use of risk scoring in a remote and high-risk pregnant population.

The Peninsula and Torres Strait Health Region in Far North Queensland is a large and remote region with a high incidence of at-risk pregnancies and few experienced caregivers to provide antenatal care. Pregnancy Risk Scoring was trialled as a means of best allocating meagre resources. All 3,679 women with singleton pregnancies who gave birth at Cairns Base Hospital were studied over a 30-month period, during which time the Hospital and Regional perinatal mortality rates fell by more than 50%. Risk scoring was applied to 2,875 of these pregnancies. Preterm birth, the birth of low birth-weight babies, and birth intervention were less likely to occur in those women with a low-risk score, with the lower likelihood of preterm birth reaching clear statistical significance. Where pregnancy care resources are scarce and large numbers of high-risk pregnant women are scattered throughout a remote area it would appear that risk scoring assists positively with decisions about the best use of resources.

Adult↗

PubMed2003

The diabetes risk score: a practical tool to predict type 2 diabetes risk.

OBJECTIVE: Interventions to prevent type 2 diabetes should be directed toward individuals at increased risk for the disease. To identify such individuals without laboratory tests, we developed the Diabetes Risk Score. RESEARCH DESIGN AND METHODS: A random population sample of 35- to 64-year-old men and women with no antidiabetic drug treatment at baseline were followed for 10 years. New cases of drug-treated type 2 diabetes were ascertained from the National Drug Registry. Multivariate logistic regression model coefficients were used to assign each variable category a score. The Diabetes Risk Score was composed as the sum of these individual scores. The validity of the score was tested in an independent population survey performed in 1992 with prospective follow-up for 5 years. RESULTS: Age, BMI, waist circumference, history of antihypertensive drug treatment and high blood glucose, physical activity, and daily consumption of fruits, berries, or vegetables were selected as categorical variables. Complete baseline risk data were found in 4435 subjects with 182 incident cases of diabetes. The Diabetes Risk Score value varied from 0 to 20. To predict drug-treated diabetes, the score value >or=9 had sensitivity of 0.78 and 0.81, specificity of 0.77 and 0.76, and positive predictive value of 0.13 and 0.05 in the 1987 and 1992 cohorts, respectively. CONCLUSIONS: The Diabetes Risk Score is a simple, fast, inexpensive, noninvasive, and reliable tool to identify individuals at high risk for type 2 diabetes.

Cross-Sectional Studies↗

PubMed2006

Birth size and coronary heart disease risk score in young adulthood. The Atherosclerosis Risk in Young Adults (ARYA) study.

Data of the Atherosclerosis Risk in Young Adults (ARYA) study were used to investigate the association between birth size and the absolute risk for coronary heart disease in healthy young adults. The cohort study comprises 750 (46.9% men) subjects born between 1970 and 1973. Birth characteristics were obtained from school health records. At young adulthood, blood pressure, anthropometry and fasting lipid levels were measured. Questionnaires were taken about smoking and diabetes. The young adult 10-year risk for coronary heart disease was calculated using the Framingham risk score. The overall 10-year risk for coronary heart disease was 1.6% (standard deviation (SD) 1.9), 3.0% (SD 1.9) in men and 0.3% (SD 0.2) in women. Using linear regression it was shown that a SD lower birth weight (=0.54 kg) was associated with 0.1% greater risk in the overall population (95% confidence interval (CI): -0.19, -0.004). Similarly, a lower ponderal index at birth was associated with an 0.11% higher risk (95% CI: -0.21, -0.002). These relations were stronger in men. Lower birth length was related with an increased risk in women (-0.02% risk/SD birth length; 95% CI: -0.04, 0.0001). These results suggest that small birth size is associated with an increased risk score for coronary artery disease in young adulthood.

Adult↗

PubMed2006

Frequency and clinical correlates of changes in Thrombolysis In Myocardial Infarction risk score during observation period at emergency department in "low-risk" patients with acute chest pain.

Among 4,333 patients who were triaged in the emergency department (ED) over a 1-year period in 2003 because of acute chest pain, 1,747 (40%) were stratified as "low risk" on the basis of a Thrombolysis In Myocardial Infarction (TIMI) risk score of 0 to 2. Results showed that, during ED stay, TIMI risk score increased to > or =3 in 63% of patients and that such patients were more likely to be diabetic, hypertensive, hyperlipidemic, and smokers, and to have had previous myocardial infarction or revascularization. Patients with changes in TIMI risk score were admitted more often to the hospital, whereas more patients with unchanged TIMI risk score were discharged home directly from the ED. In conclusion, TIMI risk score may change soon after arrival to the ED in 50% of patients with acute chest pain who are initially triaged as low risk. Changes in TIMI risk score are more common in patients with multiple risk factors and/or previous diagnosis of coronary artery disease. Serial, frequent assessments of TIMI score during the ED observation period are mandatory, particularly in these subsets of patients.

Biomarkers↗

PubMed1989

Evaluation of risk scoring in a preterm birth prevention study of indigent patients.

A total of 4591 indigent patients were scored for risk of preterm labor and birth by the Creasy et al. scoring system and delivered at greater than or equal to 20 weeks' gestation. Of 462 preterm deliveries (less than 37 weeks), only 39.6% were contributed by the 18.1% of patients who scored at high risk (score greater than or equal to 10). Of the 44 risk factors in the scoring system, 25 were not statistically significant by univariate chi 2 analysis. The spontaneous preterm birth rate was 8.0%. The positive predictive value of the Creasy et al. system was 18.3%. With multiple logistic analyses we excluded infrequent risk factors and identified five factors that remained significant (prepregnancy weight less than 45.5 kg, black race, single marital status, one preterm labor and delivery, preterm labor, and delivery greater than or equal to 2). With these five risk factors we created an equation that allowed identification of 12% of patients at high risk of preterm delivery with a positive predictive value of 21.9%. Because of the importance of previous preterm delivery, risk scoring of primigravid patients is of limited value.

Black or African American↗