Background: We realized the need for adaptive criteria based on evidence when evaluating whether to employ an early discharge AMI (Acute Myocardial Infarction) clinical pathway. Therefore, we assessed risk scores reported in western countries and the appropriateness of using these risk scores as an index to predict mortality and as adaptive criteria.

Object and Method: A total of 237 AMI patients admitted to St. Luke’s International Hospital from November 2007 to October 2010 were analyzed. We assessed these patients using two risk scoring systems (the Cadillac risk score and the Zwolle risk score) and analyzed their short term (30 day) and long term (1 year) mortality rates.

Results: 85 (36%) of the patients were assessed to be low risk under the Cadillac scoring system, whereas 155 (65%) were assessed to be low risk under the Zwolle scoring system. The short term and long term mortality rates were both 0% for low risk patients under the Cadillac system. Under the Zwolle system, the short term mortality rate was 2.6% and the long term mortality rate was 5.8%. The clinical pathway was adapted for patients assessed to be low risk under the Cadillac system, and they were hospitalized for 7.2 ± 2.5 days.

Conclusion: The Cadillac risk score is useful for risk classification of AMI patients and appropriate for use in adaptive criteria when evaluating whether to employ an early discharge clinical pathway.