TITLE:
Predictive Performance of the Get-With-The-Guidelines Heart Failure (GWTG-HF) Score for In-Hospital Mortality in Cameroonians Admitted in 2025 at Laquintinie Hospital Douala
AUTHORS:
Djibrilla Siddikatou, Christian Ngongang Ouankou, Valérie Ndobo, Marie Solange Ndom, Sidick Mouliom, Edgar Mandeng Ma Linwa, Alexia Mboulley, Raissa Tchounja Kamgang, Lok Xaviere Audrey Ndoumou, Hermann Nestor Tsague Kegni, Sylvia Kotta, Félicité Kamdem
KEYWORDS:
Heart Failure, GWTG-HF Score, In-Hospital Mortality, Sub-Saharan Africa, Risk Prediction, Discriminative Performance
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.15 No.4,
April
3,
2026
ABSTRACT: Background: The Get With The Guidelines-Heart Failure (GWTG-HF) risk score predicts in-hospital mortality in heart failure patients, but its performance in Sub-Saharan African settings remains largely unevaluated. This study assessed the discriminative ability and calibration of the GWTG-HF score in a prospective cohort at a tertiary hospital in Cameroon. Methods: Adults (≥18 years) hospitalized primarily for acute decompensated heart failure (including both de novo presentations and exacerbations of chronic heart failure), confirmed by Framingham criteria plus echocardiography, at Laquintinie Hospital, Douala, Cameroon, between January and December 2025 were included. Exclusion criteria included incomplete data for GWTG-HF variables or alternative primary diagnoses (e.g., acute coronary syndrome as dominant presentation, primary pulmonary embolism, or sepsis without HF decompensation). The primary outcome was in-hospital mortality. As primary external validation, observed mortality was compared with original GWTG-HF predicted probabilities in predetermined risk groups (0 - 33: Results: Of 193 patients (median age 65 years [IQR 52 - 73], 50.8% male), in-hospital mortality was 16.6% (32 deaths). GWTG-HF score ranged from 6 to 50 (median 29, IQR 23 - 34). The score showed no discriminative ability (AUC 0.494, 95% CI 0.380 - 0.608) and poor calibration, with observed mortality far exceeding expected rates (16.8% in 0 - 33 group vs expected Conclusion: The GWTG-HF score exhibited limited predictive performance and no clear risk stratification in this Cameroonian heart failure cohort. These findings suggest the need for recalibration or development of alternative tools tailored to Sub-Saharan African populations to improve risk assessment in resource-limited settings.