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)

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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 > Institute of Health and 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

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