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.


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.
  · Can be further improved by adding both hsCRP and SAP.
  · Is not improved by adding only SAP.
  · 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:

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

S. De Cosmo, M. Copetti, O. Lamacchia, A. Fontana, M. Massa, E. Morini, A. Pacilli, S.Fariello, A. Palena, A. Rauseo, R. Viti, R. Di Paola, C. Menzaghi, M. Cignarelli, F. Pellegrini, V. Trischitta
Development and validation of a predicting model of all-cause mortality in patients with type 2 diabetes mellitus
Diabetes Care. 2013 Sep;36(9):2830-5. doi: 10.2337/dc12-1906

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 high-sensitivity C-reactive protein and serum amyloid P component in predicting all-cause mortality in patients with type 2 diabetes
Manuscript under review, 2020