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- Title
A simple validated method for predicting the risk of hospitalization for worsening of heart failure in ambulatory patients: the Redin-SCORE.
- Authors
Álvarez ‐ García, Jesús; Ferrero ‐ Gregori, Andreu; Puig, Teresa; Vázquez, Rafael; Delgado, Juan; Pascual ‐ Figal, Domingo; Alonso ‐ Pulpón, Luis; González ‐ Juanatey, José R.; Rivera, Miguel; Worner, Fernando; Bardají, Alfredo; Cinca, Juan
- Abstract
Aims Prevention of hospital readmissions is one of the main objectives in the management of patients with heart failure ( HF). Most of the models predicting readmissions are based on data extracted from hospitalized patients rather than from outpatients. Our objective was to develop a validated score predicting 1-month and 1-year risk of readmission for worsening of HF in ambulatory patients. Methods and results A cohort of 2507 ambulatory patients with chronic HF was prospectively followed for a median of 3.3 years. Clinical, echocardiographic, ECG, and biochemical variables were used in a competing risk regression analysis to construct a risk score for readmissions due to worsening of HF. Thereafter, the score was externally validated using a different cohort of 992 patients with chronic HF ( MUSIC registry). Predictors of 1-month readmission were the presence of elevated natriuretic peptides, left ventricular (LV) HF signs, and estimated glomerular filtration rate ( eGFR) <60 mL/min/m2. Predictors of 1-year readmission were elevated natriuretic peptides, anaemia, left atrial size >26 mm/m2, heart rate >70 b.p.m., LV HF signs, and eGFR <60 mL/min/m2. The C-statistics for the models were 0.72 and 0.66, respectively. The cumulative incidence function distinguished low-risk (<1% event rate) and high-risk groups (>5% event rate) for 1-month HF readmission. Likewise, low-risk (7.8%), intermediate-risk (15.6%) and high-risk groups (26.1%) were identified for 1-year HF readmission risk. The C-statistics remained consistent after the external validation (<5% loss of discrimination). Conclusion The Redin- SCORE predicts early and late readmission for worsening of HF using proven prognostic variables that are routinely collected in outpatient management of chronic HF.
- Subjects
HEART failure patients; HEART failure; HOSPITAL care; HOSPITAL admission &; discharge; AMBULATORY patient groups; ELECTROCARDIOGRAPHY; MANAGEMENT
- Publication
European Journal of Heart Failure, 2015, Vol 17, Issue 8, p818
- ISSN
1388-9842
- Publication type
Article
- DOI
10.1002/ejhf.287