Development and validation of a prognostic score for 30-day mortality in acute coronary syndrome patients in Oran

Acute coronary syndrome (ACS) is a heterogeneous and severe acute cardiovascular event, with an early mortality rate estimated at 10.5% in western Algeria. Existing ischemic risk stratifi cation scores for ACS vary in complexity and present certain limitations. The primary objective of this study is to develop and validate a prognostic score for ACS, based on a cohort of patients admitted to the three cardiology departments of Oran ; University Hospital Establishment (UHE), University Hospital Center (UHC) and Regional Military University Hospital (RMUH), with the aim of predicting 30-day mortality. This epidemiological, multicenter, observational study included all patients hospitalized for ACS between 2018 and 2020, with 30-day all-cause mortality as the primary endpoint. The fi nal predictive model was derived using binary logistic regression in a cohort representing 71% of the initial population, while the remaining 29% was used for validation. Model calibration was assessed using the Hosmer-Lemeshow test, and discrimination was evaluated based on the area under the Receiver Operating Characteristic (ROC) curve and C-statistic. A total of 1692 eligible patients were recruited, with a predominance of males (75%) and a mean age of 61 ± 12 years. The developed score consists of seven independent dichotomous variables, yielding a maximum total of ten points. It demonstrated good calibration (p = 0.906) and a discrimination of 0.76 [95% CI: 0.73-0.78] in the derivation cohort, compared to 0.71 [95% CI: 0.66-0.75] in the validation cohort. A new, simple, reproducible, and validated decision-support tool is proposed for practitioners. This prognostic score, designed to be quickly and easily calculated, provides an effective means of predicting 30-day mortality in ACS patients and is well-suited to emergency department practices.