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EAARN Score, a Predictive Score for Mortality in Patients Receiving Cardiac Resynchronization Therapy Based on Pre-implantation Risk Factors

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May aid mortality risk stratification in CRT recipients; leaves open external validation before clinical adoption.

Identify pre-implantation predictors of mortality in patients receiving cardiac resynchronization therapy (CRT) and develop a risk score to estimate post-treatment survival.
Prospective cohort analysis of 608 consecutive heart failure patients undergoing CRT between 2000 and 2011 with a mean follow-up of 36.2 ± 29.2 months.
Baseline clinical and echocardiographic variables were analyzed alongside mortality endpoints using multivariate regression to construct the EAARN scoring system.
Multivariate mortality predictors included NYHA class IV (HR 2.54, 95% CI 1.7–3.7, P < 0.001), LVEF <22% (HR 1.83, 95% CI 1.33–2.52, P ≤ 0.001), AF (HR 1.67, 95% CI 1.19–2.3, P = 0.01), GFR <60 mL/min/1.73 m² (HR 1.61, 95% CI 1.14–2.30, P = 0.008), and age ≥70 years (HR 1.44, 95% CI 1.04–2.00, P = 0.02).
Cumulative EAARN score demonstrated escalating mortality risks for one predictor (HR 3.28, 95% CI 1.37–7.8, P = 0.008), two (HR 5.23, 95% CI 2.24–12.10, P < 0.001), three (HR 9.63, 95% CI 4.1–22.60, P < 0.001), and four or more (HR 14.38, 95% CI 5.8–35.65, P < 0.001).

Khatib et al. (2014) studied this question.

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