Skor WATCH-DM sebagai Prediktor Lama Masa Rawat Inap Pada Pasien Gagal Jantung dengan Diabetes Melitus Tipe 2 di Rumah Sakit Adam Malik Medan

Abstract

Introduction. Length of stay (LOS) is an important indicator for assessing service optimization and cost efficiency in patients with heart failure and type 2 diabetes mellitus (T2DM). The WATCH-DM score, developed in Egypt, has shown promising results but has not yet undergone external validation. Objective. To perform an external validation of the WATCH-DM score. Methods. WATCH-DM score variables were collected retrospectively at hospital admission. These data were used to externally validate the WATCH-DM score in patients with heart failure and T2DM admitted to Adam Malik Hospital. Patient characteristics, WATCH-DM scores, sensitivity, specificity, and the area under the curve (AUC) were calculated and compared with the Egyptian study as a reference. Results. A total of 77 patients were analyzed. The mean LOS was 5 days, shorter than the 11 days reported in the Egyptian study. The sensitivity and specificity of the WATCH-DM score in this study were 57% and 44%, respectively, lower than those reported in the Egyptian cohort. The AUC was 0.58 (95% CI 0.38–0.77), substantially lower than the value of 0.93 in the original study. Conclusion. The validity of the WATCH-DM score in this population was inadequate and did not match its performance in the Egyptian cohort. This score cannot yet be recommended for identifying patients at high risk of prolonged hospitalization.