External Validation of the ELAN-HF Score, Predicting 6-Month All-Cause Mortality in Patients Hospitalized for Acute Decompensated Heart Failure

• Type: Article in International Scientific Journal
• Date: 2019

Authors

Salah, K (Author) Other; Stienen, S (Author) Other; Moons, AHM (Author) Other; Bakx, ALM (Author) Other; van Pol, PE (Author) Other; Kortz, RAM (Author) Other; Ferreira, JP (Author) FMUP; Marques, I (Author) Other; Schroeder Tanka, JM (Author) Other; Keijer, JT (Author) Other; Bayes Genis, A (Author) Other; Pinto, YM (Author) Other; Tijssen, JG (Author) Other; Kok, WE (Author) Other

Journal

Title: Journal of the American Heart Association

Vol. 8

ISSN: 2047-9980

Publisher: Wiley-Blackwell

Indexing

ISI Web of Knowledge - 4 Citations

Other information

Authenticus ID: P-00R-2VQ

DOI: 10.1161/jaha.118.010309

Abstract (EN): Background-Our aim was to calibrate and externally revalidate the ELAN-HF (European Collaboration on Acute Decompensated Heart Failure) score, to confirm and improve on a previous external validation of the risk score. Methods and Results-The ELAN-HF score predicts 6-month all-cause mortality in patients hospitalized for acute decompensated heart failure using absolute and percentage change of NT-proBNP (N-terminal pro-B-type natriuretic peptide) levels in addition to clinical variables. For the external validation, we used the PRIMA II (Can NT-proBNP-Guided Therapy During Hospital Admission for Acute Decompensated Heart Failure Reduce Mortality and Readmissions?) trial. For both data sets, observed versus predicted mortality was compared for the 4 risk categories; and the mean predicted mortality was plotted against the observed mortality with calculation of a correlation coefficient and SEE. The model discriminant ability was determined by comparing the C-statistics for both data sets. The predicted versus actual 6-month mortality values in the derivation cohort were 3.7% versus 3.6% for the low-risk category, 9.4% versus 9.2% for the intermediate-risk category, 24.2% versus 23.5% for the high-risk category, and 54.2% versus 51.1% for the very-high-risk category. The correlation between predicted and observed mortality by deciles was 0.92, with an SEE of +/- 4%. In the validation cohort, predicted versus actual 6-month mortality values were 3.0% versus 2.2% for the low-risk category, 9.4% versus 8.2% for the intermediate-risk category, 25.0% versus 22.9% for the high-risk category, and 56.8% versus 53.6% for the very-high-risk category. The correlation between predicted and actual mortality by quintiles was 0.99, with an SEE of +/- 2%. There was no significant difference in C-statistic between the derivation cohort (0.78; 95% CI, 0.74-0.82) and the validation cohort (0.77; 95% CI, 0.69-0.84; P 0.693). Conclusions-Our study confirms that the ELAN-HF score predicts accurately 6-month mortality in patients hospitalized for acute decompensated heart failure with the use of easily obtained characteristics.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 11