Abstract：
OBJECTIVE: The Killip scale remains a fundamental tool for prognostic assessment in ST-segment elevation myocardial infarction (STEMI) due to its simplicity and predictive value. Lung ultrasound (LUS) has emerged as a valuable adjunct for diagnosing and predicting outcomes in heart failure (HF) and STEMI patients, even those with subclinical congestion. We created a new classification (Killip pLUS), which reclassifies Killip I and II patients into an intermediate category (Killip I pLUS) based on LUS results. This category included Killip I patients and ≥1 positive zone (≥3 B-lines) and Killip II with 0 positive zones. We aimed to evaluate this new classification by comparing it with the Killip scale and a previous LUS-based reclassification scale (LUCK scale).
RESULTS: Lung ultrasound was performed within 24 h of admission in a multicentre cohort of 373 patients admitted for STEMI. In-hospital mortality and major adverse cardiovascular events within one year after admission, comprising mortality or readmission for HF, acute coronary syndrome, or stroke, were analysed. When predicting in-hospital mortality, the global comparison of these three classifications was statistically significant: Killip pLUS area under the curve (AUC) 0.90 (95% CI 0.85-0.95) vs. Killip AUC 0.85 (95% CI 0.73-0.96) vs. LUCK 0.83 (95% CI 0.70-0.95), P = 0.024. To predict events during follow-up, the comparison between scales was also significant: Killip pLUS 0.77 (95% CI 0.71-0.85) vs. Killip 0.72 (95% CI 0.65-0.79) vs. LUCK 0.73 (95% CI 0.66-0.81), P = 0.033.
CONCLUSIONS: The Killip pLUS scale provides enhanced risk stratification compared to the Killip and LUCK scales while preserving simplicity.
RESULTS: Lung ultrasound was performed within 24 h of admission in a multicentre cohort of 373 patients admitted for STEMI. In-hospital mortality and major adverse cardiovascular events within one year after admission, comprising mortality or readmission for HF, acute coronary syndrome, or stroke, were analysed. When predicting in-hospital mortality, the global comparison of these three classifications was statistically significant: Killip pLUS area under the curve (AUC) 0.90 (95% CI 0.85-0.95) vs. Killip AUC 0.85 (95% CI 0.73-0.96) vs. LUCK 0.83 (95% CI 0.70-0.95), P = 0.024. To predict events during follow-up, the comparison between scales was also significant: Killip pLUS 0.77 (95% CI 0.71-0.85) vs. Killip 0.72 (95% CI 0.65-0.79) vs. LUCK 0.73 (95% CI 0.66-0.81), P = 0.033.
CONCLUSIONS: The Killip pLUS scale provides enhanced risk stratification compared to the Killip and LUCK scales while preserving simplicity.
摘要：
目的：Killip量表由于其简单性和预测价值，仍然是ST段抬高型心肌梗死（STEMI）预后评估的基本工具。肺超声（LUS）已成为诊断和预测心力衰竭（HF）和STEMI患者预后的有价值的辅助手段。甚至那些有亚临床充血的人.我们创建了一个新的分类(KillippLUS)，根据LUS结果将KillipI和II患者重新分类为中间类别（KillipIpLUS）。该类别包括KillipI患者和≥1个阳性区（≥3个B线）和KillipII患者，其中0个阳性区。我们旨在通过将其与Killip量表和以前基于LUS的重新分类量表（LUCK量表）进行比较来评估此新分类。
结果：在373例STEMI患者的多中心队列中，在入院24小时内进行了LUS检查。入院后一年内的住院死亡率和主要不良心血管事件（MACE），包括死亡率或心力衰竭（HF）的再入院，急性冠脉综合征,或中风，进行了分析。在预测住院死亡率时，这三种分类的全球比较具有统计学意义：KillippLUSAUC0.90（95％CI0.85-0.95）与KillipAUC0.85（95%CI0.73-0.96）与运气0.83（95%CI0.70-0.95），p=0.024。为了预测随访期间的事件，量表之间的比较也有统计学意义：KillippLUS0.77（95％CI0.71-0.85）与基利普0.72（95%CI0.65-0-79）与运气0.73（95%CI0.66-0.81），p=0.033。
结论：与Killip和LUCK量表相比，KillippLUS量表提供了增强的风险分层，同时保持了简单性。
结果：在373例STEMI患者的多中心队列中，在入院24小时内进行了LUS检查。入院后一年内的住院死亡率和主要不良心血管事件（MACE），包括死亡率或心力衰竭（HF）的再入院，急性冠脉综合征,或中风，进行了分析。在预测住院死亡率时，这三种分类的全球比较具有统计学意义：KillippLUSAUC0.90（95％CI0.85-0.95）与KillipAUC0.85（95%CI0.73-0.96）与运气0.83（95%CI0.70-0.95），p=0.024。为了预测随访期间的事件，量表之间的比较也有统计学意义：KillippLUS0.77（95％CI0.71-0.85）与基利普0.72（95%CI0.65-0-79）与运气0.73（95%CI0.66-0.81），p=0.033。
结论：与Killip和LUCK量表相比，KillippLUS量表提供了增强的风险分层，同时保持了简单性。
