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

Key words: Acute heart failure, MEESSI-AHF, mortality.