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Author Spotlight: Unveiling Prognostic Indicators in Heart Failure - The Role of Phase Angle and Bioelectrical Impedance Analysis
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Author Spotlight: Unveiling Prognostic Indicators in Heart Failure - The Role of Phase Angle and Bioelectrical Impedance Analysis

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

R Quirós-López1, L Manzano-Espinosa2, A Bilbao3

  • 1Internal Medicine Unit, Costa del Sol Hospital, Marbella, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Spain; RICA Registry, Spain.

European Journal of Internal Medicine
|June 15, 2019
PubMed

Insights

The CACE-HF risk score accurately predicts 1-year mortality in heart failure patients, showing excellent calibration in external validation. This tool aids clinical decision-making for heart failure management.

Area of Science:

  • Cardiology
  • Clinical Epidemiology
  • Health Outcomes Research

Background:

  • Heart failure (HF) poses a significant mortality risk.
  • Accurate prediction of mortality is crucial for effective HF management.
  • The CACE-HF clinical prediction rule was developed to estimate 1-year mortality in HF patients.

Purpose of the Study:

  • To externally validate the CACE-HF clinical prediction rule.
  • To assess the performance of the CACE-HF score in a new patient cohort.

Main Methods:

  • External validation of the CACE-HF risk score using the RICA heart failure registry.
  • Comparison of derivation and validation cohorts' characteristics.
  • Evaluation of discrimination using the area under the ROC curve (AUC).
  • Assessment of calibration using calibration-in-the-large (a), calibration slope (b), and the Hosmer-Lemeshow test.

Main Results:

  • The validation cohort included 3337 patients.
  • 1-year mortality was 22.98% in the validation cohort, similar to the derivation cohort.
  • Discrimination was slightly lower in the validation cohort (AUC = 0.67) compared to the derivation cohort.
  • Calibration was excellent, with minimal difference between predicted and observed mortality.

Conclusions:

  • The CACE-HF risk score demonstrates excellent calibration in an external validation cohort.
  • While discrimination was slightly reduced, the tool remains valuable for clinical decision-making in heart failure management.
  • External validation supports the utility of the CACE-HF score in diverse heart failure populations.
Abstract

Keywords:
Clinical prediction ruleHeart failure

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