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.