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The Usefulness of the MEESSI Score for Risk Stratification of Patients With Acute Heart Failure at the Emergency Department

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Miro, O
  • Rossello, X
  • Gil, V
  • Martin-Sanchez, FJ
  • Llorens, P
  • Herrero, P
  • Jacob, J
  • Lopez-Grima, ML
  • Gil, C
  • Imbernon, FJL
  • Garrido, JM
  • Lopez-Diez, MP
  • Richard, F
  • Bueno, H
  • Pocock, SJ

Grupos

Abstract

Introduction and objectives: The MEESSI scale stratifies acute heart failure (AHF) patients at the emergency department (ED) according to the 30-day mortality risk. We validated the MEESSI risk score in a new cohort of Spanish patients to assess its accuracy in stratifying patients by risk and to compare its performance in different settings. Methods: We included consecutive patients diagnosed with AHF in 30 EDs during January and February 2016. The MEESSI score was calculated for each patient. The c-statistic measured the discriminatory capacity to predict 30-day mortality of the full MEESSI model and secondary models. Further comparisons were made among subgroups of patients from university and community hospitals, EDs with high-, medium- or low-activity and EDs that recruited or not patients in the original MEESSI derivation cohort. Results: We analyzed 4711 patients (university/community hospitals: 3811/900; high-/medium-/low activity EDs: 2695/1479/537; EDs participating/not participating in the previous MEESSI derivation study: 3892/819). The distribution of patients according to the MEESSI risk categories was: 1673 (35.5%) low risk, 2023 (42.9%) intermediate risk, 530 (11.3%) high risk and 485 (10.3%) very high risk, with 30 day mortality of 2.0%, 7.8%, 17.9%, and 41.4%, respectively. The c-statistic for the full model was 0.810 (95%Cl, 0.790-0.830), ranging from 0.731 to 0.785 for the subsequent secondary models. The discriminatory capacity of the MEESSI risk score was similar among subgroups of hospital type, ED activity, and original recruiter EDs. Conclusions: The MEESSI risk score successfully stratifies AHF patients at the ED according to the 30-day mortality risk, potentially helping clinicians in the decision-making process for hospitalizing patients. Full English text available from: www.revespcardiol.org/en (C) 2018 Sociedad Espanola de Cardiologla. Published by Elsevier Espana, S.L.U. All rights reserved.

Datos de la publicación

ISSN/ISSNe:
0300-8932, 1579-2242

REVISTA ESPANOLA DE CARDIOLOGIA  EDICIONES DOYMA S A

Tipo:
Article
Páginas:
198-207
PubMed:
29903688
Factor de Impacto:
0,473 SCImago ℠
Cuartil:
Q3 SCImago ℠

Citas Recibidas en Web of Science: 27

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Keywords

  • Acute heart failure; Risk stratification; Risk score; Mortality; Outcome; Emergency department

Campos de Estudio

Proyectos y Estudios Clínicos

PRAGMATIC, CONTROLLED, INTERNATIONAL STUDY CONDUCTED IN SEVERAL CENTRES ON THE SAFETY AND THERAPEUTIC EFFECT OF A HYDROXYLETHYL-STARCH (HES) SOLUTION VERSUS AN ELECTROLYTE SOLUTION IN TRAUMA PATIENTS.

Investigador Principal: ÓSCAR DÍAZ CAMBRONERO

HC-G-H-1505 . 2018

EFECTO DE V0251 EN EL VÉRTIGO AGUDO. ESTUDIO ALEATORIZADO, DOBLE CIEGO Y CONTROLADO CON PLACEBO.

Investigador Principal: HERMINIO PÉREZ GARRIGUES

V00251IV2024A

PERFIL DE RIESGO DE LOS PACIENTES CON ETV EN HOSPITALES ESPAÑOLES ATENDIDOS EN LOS SERVICIOS DE URGENCIAS E IMPACTO ASISTENCIAL: REGISTRO ESPHERIA.

Investigador Principal: MARÍA JOSÉ PÉREZ DURÁ

ESPHERIA

PLANIFICACIÓN DEL ALTA DESDE URGENCIAS PARA REDUCIR REINGRESOS A 30 DÍAS EN MAYORES FRÁGILES CON INSUFICIENCIA CARDÍACA AGUDA: ENSAYO CLÍNICO ALEATORIZADO POR CONGLOMERADOS PAREADO.

Investigador Principal: CARMEN GARGALLO MAICAS

DEED FRAIL-AHF . 2019

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