Added value of frailty and social support in predicting risk of 30-day unplanned re-admission or death for patients with heart failure: an analysis from OPERA-HF

Sokoreli, I., Cleland, J.G. , Pauws, S.C., Steyerberg, E.W., de Vries, J.J.G., Riistama, J.M., Dobbs, K., Bulemfu, J. and Clark, A.L. (2019) Added value of frailty and social support in predicting risk of 30-day unplanned re-admission or death for patients with heart failure: an analysis from OPERA-HF. International Journal of Cardiology, 278, pp. 167-172. (doi: 10.1016/j.ijcard.2018.12.030) (PMID:30587417)

Abstract

Background: Models for predicting the outcome of patients hospitalized for heart failure (HF) rarely take a holistic view. We assessed the ability of measures of frailty and social support in addition to demographic, clinical, imaging and laboratory variables to predict short-term outcome for patients discharged after a hospitalization for HF. Methods: OPERA-HF is a prospective observational cohort, enrolling patients hospitalized for HF in a single center in Hull, UK. Variables were combined in a logistic regression model after multiple imputation of missing data to predict the composite outcome of death or readmission at 30 days. Comparisons were made to a model using clinical variables alone. The discriminative performance of each model was internally validated with bootstrap re-sampling. Results: 1094 patients were included (mean age 77 [interquartile range 68–83] years; 40% women; 56% with moderate to severe left ventricular systolic dysfunction) of whom 213 (19%) had an unplanned re-admission and 60 (5%) died within 30 days. For the composite outcome, a model containing clinical variables alone had an area under the receiver-operating characteristic curve (AUC) of 0.68 [95% CI 0.64–0.72]. Adding marital status, support from family and measures of physical frailty increased the AUC (p < 0.05) to 0.70 [95% CI 0.66–0.74]. Conclusions: Measures of physical frailty and social support improve prediction of 30-day outcome after an admission for HF but predicting near-term events remains imperfect. Further external validation and improvement of the model is required.

• Item Type: Articles
• Keywords: 30-day re-admission, frailty, heart failure, mortality, psychosocial factors.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Cleland, Professor John
• Authors: Sokoreli, I., Cleland, J.G., Pauws, S.C., Steyerberg, E.W., de Vries, J.J.G., Riistama, J.M., Dobbs, K., Bulemfu, J., and Clark, A.L.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: International Journal of Cardiology
• Publisher: Elsevier
• ISSN: 0167-5273
• ISSN (Online): 1874-1754
• Published Online: 13 December 2018
• Copyright Holders: Copyright © 2018 Elsevier B.V.
• First Published: First published in International Journal of Cardiology 278:167-172
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher