ArticleMedical archives (Sarajevo, Bosnia and Herzegovina)2026
MEESSI-AHF Score for Predicting In-Hospital Mortality in Vietnamese Acute Heart Failure.
Article in Medical archives (Sarajevo, Bosnia and Herzegovina), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The MEESSI-AHF score is widely recommended for 30-day risk stratification in acute heart failure (AHF), but its ability to predict in-hospital mortality - an endpoint with immediate implications for triage and resource allocation - has not been evaluated in Vietnam. Objective: This study externally validated MEESSI-AHF for in-hospital mortality in Vietnamese patients hospitalized with AHF, assessing both discrimination and calibration. Methods: A prospective cohort of adults hospitalized with AHF (Sep 2024 - Mar 2025; n = 241) was analyzed. The endpoint was in-hospital mortality; performance was assessed by AUC and calibration (CITL, slope, Brier, HL g=6, plots), with minimal recalibration (intercept/slope) if needed. Results: In-hospital mortality was 10.8% (26/241). MEESSI-AHF scores were higher in non-survivors than survivors (median 0.49 vs - 2.17; p<0.001) and showed excellent discrimination (AUC 0.886, 95% CI 0.832 - 0.940). Observed mortality increased stepwise across six pre-specified strata (p for trend < 0.001). Overall calibration suggested over-prediction (CITL -1.201, 95% CI -1.665 to -0.737; slope 1.118, 95% CI 0.734 - 1.502), with Brier score 0.092 (Brier skill 0.042) and poor HL fit (g=6: χ²=28.44, p < 0.001), mainly in the highest-risk stratum. Relative to low-intermediate risk, mortality was higher in high-risk (OR 17.55, 95% CI 1.89 - 162.51) and very-high-risk groups (OR 57.12, 95% CI 7.49 - 435.83). Conclusion: In Vietnamese patients hospitalized with AHF, MEESSI-AHF shows excellent discrimination for in-hospital mortality but systematically overpredicts risk; minimal recalibration corrects this and supports its use for bedside triage with local adjustment.
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