Friday September 26, 2008
KILLIP Classification

The Killip classification (designed about 40 years ago) is a system used in individuals with an acute myocardial infarction (heart attack), in order to risk stratify them. Individuals with a low Killip class are less likely to die within the first 30 days after their myocardial infarction than individuals with a high Killip class.

Patients were ranked by Killip class in the following way:

Killip class I includes individuals with no clinical signs of heart failure
Killip class II includes individuals with rales or crackles in the lungs an S3 gallop, and elevated jugular venous pressure.
Killip class III describes individuals with frank acute pulmonary edema.
Killip class IV describes individuals in cardiogenic shock or hypotension (measured as SBP lower than 90 mmHg), and evidence of peripheral vasoconstriction (oliguria, cyanosisor sweating).


Mortality rate based on Killip classification

Killip class I: 81/250 patients; 32% (27 to 38%). Mortality rate was found to be at 6%.
Killip class II: 96/250 patients; 38% (32 to 44%). Mortality rate was found to be at 17%.
Killip class III: 26/250 patients; 10% (6.6 to 14%). Mortality rate was found to be at 38%.
Killip class IV: 47/250 patients; 19% (14 to 24%). Mortality rate was found to be at 81%.



Killip T, Kimball JT. Treatment of myocardial infarction in a coronary care unit: a two year experience of 250 patients. Am J Cardiol 1967; 20: 457-464.