Background: The MEESSI-AHF (Multiple Estimation of risk based on the Emergency department Spanish Score In patients with AHF) score was developed to predict 30-day mortality in patients presenting with acute heart failure (AHF) to emergency departments (EDs) in Spain. Whether it performs well in other countries is unknown. Objective: To externally validate the MEESSI-AHF score in another country. Design: Prospective cohort study. (ClinicalTrials.gov: NCT01831115). Setting: Multicenter recruitment of dyspneic patients presenting to the ED. Participants: The external validation cohort included 1572 patients with AHF. Measurements: Calculation of the MEESSI-AHF score using an established model containing 12 independent risk factors. Results: Among 1572 patients with adjudicated AHF, 1247 had complete data that allowed calculation of the MEESSI-AHF score. Of these, 102 (8.2%) died within 30 days. The score predicted 30-day mortality with excellent discrimination (c-statistic, 0.80). Assessment of cumulative mortality showed a steep gradient in 30-day mortality over 6 predefined risk groups (0 patients in the lowest-risk group vs. 35 [28.5%] in the highest-risk group). Risk was overestimated in the high-risk groups, resulting in a Hosmer-Lemeshow P value of 0.022. However, after adjustment of the intercept, the model showed good concordance between predicted risks and observed outcomes (P = 0.23). Findings were confirmed in sensitivity analyses that used multiple imputation for missing values in the overall cohort of 1572 patients. Limitations: External validation was done using a reduced model. Findings are specific to patients with AHF who present to the ED and are clinically stable enough to provide informed consent. Performance in patients with terminal kidney failure who are receiving long-term dialysis cannot be commented on. Conclusion: External validation of the MEESSI-AHF risk score showed excellent discrimination. Recalibration may be needed when the score is introduced to new populations. Primary Funding Source: The European Union, the Swiss National Science Foundation, the Swiss Heart Foundation, the Cardiovascular Research Foundation Basel, the University of Basel, and University Hospital Basel.
Background: The MEESSI-AHF (Multiple Estimation of risk based on the Emergency department Spanish Score In patients with AHF) score was developed to predict 30-day mortality in patients presenting with acute heart failure (AHF) to emergency departments (EDs) in Spain. Whether it performs well in other countries is unknown. Objective: To externally validate the MEESSI-AHF score in another country. Design: Prospective cohort study. (ClinicalTrials.gov: NCT01831115). Setting: Multicenter recruitment of dyspneic patients presenting to the ED. Participants: The external validation cohort included 1572 patients with AHF. Measurements: Calculation of the MEESSI-AHF score using an established model containing 12 independent risk factors. Results: Among 1572 patients with adjudicated AHF, 1247 had complete data that allowed calculation of the MEESSI-AHF score. Of these, 102 (8.2%) died within 30 days. The score predicted 30-day mortality with excellent discrimination (c-statistic, 0.80). Assessment of cumulative mortality showed a steep gradient in 30-day mortality over 6 predefined risk groups (0 patients in the lowest-risk group vs. 35 [28.5%] in the highest-risk group). Risk was overestimated in the high-risk groups, resulting in a Hosmer-Lemeshow P value of 0.022. However, after adjustment of the intercept, the model showed good concordance between predicted risks and observed outcomes (P = 0.23). Findings were confirmed in sensitivity analyses that used multiple imputation for missing values in the overall cohort of 1572 patients. Limitations: External validation was done using a reduced model. Findings are specific to patients with AHF who present to the ED and are clinically stable enough to provide informed consent. Performance in patients with terminal kidney failure who are receiving long-term dialysis cannot be commented on. Conclusion: External validation of the MEESSI-AHF risk score showed excellent discrimination. Recalibration may be needed when the score is introduced to new populations. Primary Funding Source: The European Union, the Swiss National Science Foundation, the Swiss Heart Foundation, the Cardiovascular Research Foundation Basel, the University of Basel, and University Hospital Basel.
Authors: Kuan Ken Lee; Dimitrios Doudesis; Mohamed Anwar; Federica Astengo; Camille Chenevier-Gobeaux; Yann-Erick Claessens; Desiree Wussler; Nikola Kozhuharov; Ivo Strebel; Zaid Sabti; Christopher deFilippi; Stephen Seliger; Gordon Moe; Carlos Fernando; Antoni Bayes-Genis; Roland R J van Kimmenade; Yigal Pinto; Hanna K Gaggin; Jan C Wiemer; Martin Möckel; Joost H W Rutten; Anton H van den Meiracker; Luna Gargani; Nicola R Pugliese; Christopher Pemberton; Irwani Ibrahim; Alfons Gegenhuber; Thomas Mueller; Michael Neumaier; Michael Behnes; Ibrahim Akin; Michele Bombelli; Guido Grassi; Peiman Nazerian; Giovanni Albano; Philipp Bahrmann; David E Newby; Alan G Japp; Athanasios Tsanas; Anoop S V Shah; A Mark Richards; John J V McMurray; Christian Mueller; James L Januzzi; Nicholas L Mills Journal: BMJ Date: 2022-06-13
Authors: Òscar Miró; Xavier Rossello; Elke Platz; Josep Masip; Danielle M Gualandro; W Frank Peacock; Susanna Price; Louise Cullen; Salvatore DiSomma; Mucio Tavares de Oliveira; John Jv McMurray; Francisco J Martín-Sánchez; Alan S Maisel; Christiaan Vrints; Martin R Cowie; Héctor Bueno; Alexandre Mebazaa; Christian Mueller Journal: Eur Heart J Acute Cardiovasc Care Date: 2020-08
Authors: Òscar Miró; Pia Harjola; Xavier Rossello; Víctor Gil; Javier Jacob; Pere Llorens; Francisco Javier Martín-Sánchez; Pablo Herrero; Gemma Martínez-Nadal; Sira Aguiló; María Luisa López-Grima; Marta Fuentes; José María Álvarez Pérez; Esther Rodríguez-Adrada; María Mir; Josep Tost; Lluís Llauger; Frank Ruschitzka; Veli-Pekka Harjola; Wilfried Mullens; Josep Masip; Ovidiu Chioncel; W Frank Peacock; Christian Müller; Alexandre Mebazaa Journal: Eur Heart J Acute Cardiovasc Care Date: 2021-06-30
Authors: Maximilian S Schaefer; Maximilian Hammer; Katharina Platzbecker; Peter Santer; Stephanie D Grabitz; Kadhiresan R Murugappan; Tim Houle; Sheila Barnett; Edward K Rodriguez; Matthias Eikermann Journal: Clin Orthop Relat Res Date: 2021-03-01 Impact factor: 4.755