Development and validation of multivariable models to predict mortality and hospitalization in patients with heart failure

Voors, A. A. et al. (2017) Development and validation of multivariable models to predict mortality and hospitalization in patients with heart failure. European Journal of Heart Failure, 19(5), pp. 627-634. (doi: 10.1002/ejhf.785) (PMID:28247565)

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Abstract

Introduction: From a prospective multicentre multicountry clinical trial, we developed and validated risk models to predict prospective all-cause mortality and hospitalizations because of heart failure (HF) in patients with HF. Methods and results: BIOSTAT-CHF is a research programme designed to develop and externally validate risk models to predict all-cause mortality and HF hospitalizations. The index cohort consisted of 2516 patients with HF from 69 centres in 11 European countries. The external validation cohort consisted of 1738 comparable patients from six centres in Scotland, UK. Patients from the index cohort had a mean age of 69 years, 27% were female, 83% were in New York Heart Association (NYHA) class II–III and the mean left ventricular ejection fraction (LVEF) was 31%. The full prediction models for mortality, hospitalization owing to HF, and the combined outcome, yielded c-statistic values of 0.73, 0.69, and 0.71, respectively. Predictors of mortality and hospitalization owing to HF were remarkably different. The five strongest predictors of mortality were more advanced age, higher blood urea nitrogen and N-terminal pro-B-type natriuretic peptide, lower haemoglobin, and failure to prescribe a beta-blocker. The five strongest predictors of hospitalization owing to HF were more advanced age, previous hospitalization owing to HF, presence of oedema, lower systolic blood pressure and lower estimated glomerular filtration rate. Patients from the validation cohort were aged 74 years, 34% were female, 85% were in NYHA class II–III, and mean LVEF was 41%; c-statistic values for the full and compact model were comparable to the index cohort. Conclusion: A small number of variables, which are usually readily available in the routine clinical setting, provide useful prognostic information for patients with HF. Predictors of mortality were remarkably different from predictors of hospitalization owing to HF.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cleland, Professor John
Authors: Voors, A. A., Ouwerkerk, W., Zannad, F., van Veldhuisen, D. J., Samani, N. J., Ponikowski, P., Ng, L. L., Metra, M., ter Maaten, J. M., Lang, C. C., Hillege, H. L., van der Harst, P., Filippatos, G., Dickstein, K., Cleland, J. G.F., Anker, S. D., and Zwinderman, A. H.
Subjects:R Medicine > R Medicine (General)
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:European Journal of Heart Failure
Publisher:Wiley
ISSN:1388-9842
ISSN (Online):1879-0844
Published Online:01 March 2017
Copyright Holders:Copyright © 2017 The Authors and the European Society and Cardiology
First Published:First published in European Journal of Heart Failure 19(5): 627-364
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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