The ELAN-HF score accurately predicted 6-month all-cause mortality in patients hospitalized for acute decompensated heart failure, demonstrating a validation C-statistic of 0.77 (95% CI, 0.69-0.84).
Cohort
Yes
Does the ELAN-HF score accurately predict 6-month all-cause mortality in patients hospitalized for acute decompensated heart failure?
The ELAN-HF score, which includes NT-proBNP changes and clinical variables, accurately predicts 6-month all-cause mortality in patients hospitalized for acute decompensated heart failure.
Effect estimate: C-statistic 0.77 (95% CI 0.69-0.84)
p-value: p=0.693
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.
Salah et al. (Fri,) conducted a cohort in Acute Decompensated Heart Failure. ELAN-HF score vs. Derivation cohort was evaluated on 6-month all-cause mortality (C-statistic 0.77, 95% CI 0.69-0.84, p=0.693). The ELAN-HF score accurately predicted 6-month all-cause mortality in patients hospitalized for acute decompensated heart failure, demonstrating a validation C-statistic of 0.77 (95% CI, 0.69-0.84).