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Clin Exp Emerg Med > Accepted Articles
doi: https://doi.org/10.15441/ceem.24.314    [Accepted]
Derivation and validation of a simple prognostic risk score to predict short-term mortality in acute cardiogenic pulmonary edema: SABIHA Score
Kenan Toprak1 , Mustafa Kaplangöray2, Mesut Karataş3, Zuhal Fatma Cellat4, Yakup Arğa5, Rüstem Yılmaz6, Mustafa Begenc Tascanov7, Asuman Biçer8
1Harran University, Faculty of Medicine, Department of Cardiology, Sanliurfa, Turkey
2Şeyh Edebali University, Medical Faculty, Department of Cardiology, Bilecik, Turkey
3Kartal Koşuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
4Department of Biostatistics and Medical Informatics, Yildiz Technical University, Istanbul, Turkey
5Viranşehir State Hospital, Department of Cardiology, Sanliurfa, Turkey
6Samsun University, Medical Faculty, Department of Cardiology, Samsun, Turkey
Correspondence  Kenan Toprak Tel: +90 414 318 30 00, Fax: +90 414 318 31 92, Email: kentoprak@hotmail.com
Received: September 13, 2024. Revised: October 26, 2024.  Accepted: October 29, 2024. Published online: January 15, 2025.
ABSTRACT
Objective
In the context of acute cardiogenic pulmonary edema (ACPE), a frequently encountered medical emergency associated with high early mortality rates, there is a need to predict short-term outcomes for risk stratification.Our aim was to derive and validate a model, a simple clinical scoring system using baseline vital signs, clinical and presenting characteristics, and readily available laboratory tests, that allows accurate prediction of short-term mortality in individuals experiencing ACPE.
Methods
This retrospective cohort study included 1088 patients with ACPE from six health centers. Subjects were randomly allocated into derivation and validation cohorts at a 4:3 ratio, facilitating comprehensive examination and validation of prognostic model. Independent predictors of mortality (p<0.05) from the multivariable model were included in the risk score. The discriminant ability of the score was tested by ROC analysis.
Result
s In the derivation cohort (n=623), age, blood urea nitrogen, heart rate, intubation, anemia, and systolic blood pressure were identified as independent predictors of mortality in multivariable analysis. These variables were used to develop a risk score ranging from 0 to 6 by scoring 0 and 1. The SABIHA score provided a good calibration with a concordance index of 0.879 (95% CI: 0.821-0.937). While the probability of short-term mortality was 80.0% in the high risk group, this rate was only 3.3% in the low risk group. This score also performed well on the validation set.
Conclusions
A simple clinical score consisting of routinely obtained variables can be used in risk stratification to predict short-term outcomes in patients with ACPE.
Keywords: Risk score; Short-term mortality; Acute cardiogenic pulmonary edema
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