The Osaka Prognostic Score Predicts All-Cause in-Hospital Mortality in Patients With Non-ST-Elevation Myocardial Infarction Undergoing Early Percutaneous Coronary Intervention

Abstract

The Osaka Prognostic Score (OPS) is a composite index reflecting systemic inflammation and nutritional status, derived from C-reactive protein, albumin, and lymphocyte count. This retrospective study evaluated the association between OPS and all-cause in-hospital mortality in 959 patients with non-ST-elevation myocardial infarction (NSTEMI) undergoing early percutaneous coronary intervention from September 2022 to November 2024. Patients were stratified into 4 groups based on OPS (0-3), with all-cause in-hospital mortality as the primary endpoint. Cox proportional hazards modeling was used to identify independent predictors of mortality, and receiver operating characteristic analysis assessed the prognostic performance of OPS. During hospitalization (maximum 12 days), 106 patients (11.0%) died. Non-survivors were significantly older (69.1 vs 58.9 years, P < .001) and more frequently female (36.8 vs 19%, P < .001). Independent predictors included advanced age, low diastolic blood pressure, higher Killip class, reduced left ventricular ejection fraction, elevated creatinine and troponin levels, and high OPS values (hazard ratio: 3.032; 95% confidence interval [CI]: 2.003-4.102; P < .001). An OPS threshold of 1.5 yielded 94% sensitivity and 74% specificity (95% CI: 0.859-0.937; P < .001), with mortality rates of 3.7%, 4.2%, 17.1%, and 59.1% across OPS categories (P < .001). Incorporating OPS with conventional risk factors may enhance the risk stratification of NSTEMI.