Development and validation of a simple integer risk score for prediction of in-hospital mortality following Takotsubo syndrome.

BACKGROUND: Data regarding the characteristics associated with worse outcomes in Takotsubo syndrome (TTS) patients is lacking.

METHODS AND OBJECTIVES: The National Inpatient Sample (NIS) 2012 database was utilized to calculate a risk score for in-hospital mortality following TTS that was internally and externally validated in both 2012 and 2013 databases, respectively.

RESULTS: The incidences of in-hospital mortality in the 2012 development sample were 0.2%, 3.2% and 15.6% in the low risk (≤2), intermediate risk (3-4) and high-risk (≥5) score groups, respectively. The risk score C-statistics were 0.86 and 0.88 in the development and external validation samples, respectively (p < 0.001). Age ≥ 80 year was associated with the highest odds ratio (OR) of mortality (OR 8.07, 95% confidence interval (CI) 5.79-11.25). Other important predictors were acute cerebrovascular accident and acute respiratory failure.

CONCLUSIONS: The risk of in-hospital mortality following TTS could be predicted using a simple risk score, which could aid in identifying and proper management of a higher risk group.