GermanVasc Score may Predict prognosis of Patients with Peripheral Arterial Occlusive Disease

It was a retrospective analysis of claims data, symptomatic PAOD. A total of 87293 patients with PAOD were split into training (60%) and validation (40%) sets. Patient age and gender, Elixhauser comorbidities, and the 190 most common secondary diagnoses were the variables in the model. Researchers conducted penalized Cox regression (least absolute shrinkage and selection operator) with tenfold cross-validation for variable selection and individuals were classified into five risk groups applying the ten most important variables. The major outcome assessed was death or major amputation above ankle level, measured as the composite endpoint of five-year AFS after the index hospitalisation.

Researchers determined the most important variable predicting worse five-year AFS as patient age >80 years. They found the GermanVasc score exhibited good predictive accuracy both for IC (c statistic = 0.70) and CLTI (c statistic = 0.69) with adequate calibration due largely to the alignment of observed and expected risk. Depending on the cumulative point score, they recorded a five-year risk of amputation or death ranged from 9% (low risk) to 48% (high risk) for IC, and from 25% to 88% for CLTI.

The authors concluded, "The GermanVasc score predicts worse five-year AFS stratified for inpatients suffering from IC and CLTI, with good predictive accuracy. By separating low from high-risk patients, the GermanVasc score may support patient-centred consent".

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https://www.ejves.com/article/S1078-5884(20)31006-6/fulltext?rss=yes#articleInformation