Derivation and validation of a simple prognostic risk score to predict short-term mortality in acute cardiogenic pulmonary edema: SABIHA Score.

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.

Results: 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.