The Zwolle risk score: Safe early discharge
This score is a practical and useful index for risk stratification after primary angioplasty for ST elevated myocardial infarction (STEMI), with a significant impact on clinical decision-making and the related costs. It reliably identifies a large group of patients at very low risk, who may safely be discharged early after primary angioplasty.
Research authors: Giuseppe de Luca, Harry Suryapranata, Arnoud W.J. van't Hof, Menko-Jan de Boer, Jan C.A. Hoorntje, Jan-Henk E. Dambrink, A.T. Marcel Gosselink, Jan Paul Ottervanger, Felix Zijlstra
Version: 1.5
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The Zwolle risk score is: Points

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This score was able to identify a large cohort (73.4%) of low-risk (score ≤3) patients, with a good discriminatory capacity (c statistic = 0.907). The mortality rate was 0.1% at 2 days and 0.2% between 2 and 10 days in patients with a score ≤3. The incremental cost-effectiveness ratio for late discharge in low-risk patients was estimated at €1949.33. Therefore, this policy would save 1 life per 1097 low-risk patients, at additional costs of €194 933.33, in comparison with an early discharge policy.

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