ENFORCE
ENFORCE
EstimatioN oF mORtality risk in type2 diabetiC patiEnts (ENFORCE): a validated, inexpensive and easy-to-use prediction model of 6-year all-cause mortality in patients with type 2 diabetes mellitus. [1]


Risk Score Calculation
Age (yrs)
Anti HT Tx (yes/no)
Insulin Tx (yes/no)
BMI (Kg/m2)
HDL (mg/dl)
LDL (mg/dl)
Triglyceride (mg/dl)
DBP (mm Hg)
UACR (mg/mmol)
hsCRP (mg/L)  *
SAP (mg/L)  *, **

HT Hypertension; Tx = Treatment; BMI = Body Mass Index; HDL = High Density Lipoprotein; LDL = Low Density Lipoprotein; DBP = Diastolic Blood Pressure;
UACR = Urinary Albumin Creatinine Ratio; hsCRP = high sensitive C-reactive protein; SAP = serum amyloid P component.
* Optional
** Valid only if also hsCRP value is entered

Please, note that ENFORCE:
  · Needs all the first nine variables.
  · Can be improved by adding hsCRP.
[2]
  · Can be further improved by adding both hsCRP and SAP. [2]
  · Is not improved by adding only SAP. [2]
  · Is intended to help clinicians on top of their clinical judgment.
  · Cannot be used to define individual follow-up and treatment strategies (there is still no data available for these purposes).



References:

[1] M. Copetti, H. Shah, A. Fontana, M. G. Scarale, C. Menzaghi, S. De Cosmo, A. Doria, V. Trischitta
      EstimatioN oF mORtality risk in type2 diabetiC patiEnts (ENFORCE): an inexpensive, parsimonious and easy-to-use prediction model
       J Clin Endocrinol Metab. 2019 Oct 1;104(10):4900-4908. doi: 10.1210/jc.2019-00215

[2] M. G. Scarale, M. Copetti, M. Garofolo, A. Fontana, L. Salvemini, S. De Cosmo, O. Lamacchia, G. Penno, V. Trischitta, C. Menzaghi
      The synergic association of hs-CRP and serum amyloid P component in predicting all-cause mortality in patients with type 2 diabetes
       Diabetes Care 2020 May; 43:1–8. doi: 10.2337/dc19-2489