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External validation of the CACE-HF risk score for mortality in patients with heart failure.

Abstract：

AIMS:To validate externally the CACE-HF clinical prediction rule, which predicts 1-year mortality in patients with heart failure (HF). METHODS:We performed an external validation of the CACE-HF risk score in patients included in the RICA heart failure registry who had completed 1 year of follow-up, comparing the characteristics of the derivation and validation cohorts. The performance of the risk score was evaluated in terms of calibration, using calibration-in-the-large (a), calibration slope (b), and the Hosmer-Lemeshow test, and in terms of discrimination, using the area under the ROC curve. RESULTS:In total, 3337 patients were included in the validation cohort. There were no significant differences between the derivation and validation cohorts in 1-year mortality (24.63% vs. 22.98%) or in the risk score and risk classes. The discrimination capacity in the validation cohort was slightly lower, 0.67 (95% CI: 0.65, 0.69), compared to that of the derivation cohort. Calibration results were a -0.05 (95% CI: -0.14, 0.03), indicating that the average predictions did not differ from the average outcome frequency, and b = 0.75 (95% CI: 0.64, 0.86), indicating a modest inconsistency in predictor effects. Observed mortality versus predicted mortality according to the deciles and risk classes were very similar in both cases, indicating good calibration. CONCLUSIONS:The results of the external validation of the CACE-HF risk score show that although the capacity for discrimination was slightly lower than in the derivation cohort, the calibration was excellent. This tool, therefore, can assist in decision-making in the management of these patients.

journal_name

Eur J Intern Med

journal_title

European journal of internal medicine

authors

Quirós-López R,Manzano-Espinosa L,Bilbao A,Montero Pérez-Barquero M,Cepeda-Rodrigo JM,Escobar-Martínez A

doi

10.1016/j.ejim.2019.05.010

subject

Has Abstract

pub_date

2019-08-01 00:00:00

pages

35-40

eissn

0953-6205

issn

1879-0828

pii

S0953-6205(19)30156-6

journal_volume

66

pub_type

杂志文章,多中心研究

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