The COACH risk engine: a multistate model for predicting survival and hospitalization in patients with heart failure

Postmus, D. et al. (2012) The COACH risk engine: a multistate model for predicting survival and hospitalization in patients with heart failure. European Journal of Heart Failure, 14(2), pp. 168-175. (doi: 10.1093/eurjhf/hfr163)

[img] Text
61956.pdf - Accepted Version

308kB

Abstract

Aims: Several models for predicting the prognosis of heart failure (HF) patients have been developed, but all of them focus on a single outcome variable, such as all-cause mortality. The purpose of this study was to develop a multistate model for simultaneously predicting survival and HF-related hospitalization in patients discharged alive from hospital after recovery from acute HF. <p/>Methods and results: The model was derived in the COACH (Coordinating Study Evaluating Outcomes of Advising and Counseling in Heart Failure) cohort, a multicentre, randomized controlled trial in which 1023 patients were enrolled after hospitalization because of HF. External validation was attained with the FINN-AKVA (Finish Acute Heart Failure Study) cohort, a prospective, multicentre study with 620 patients hospitalized due to acute HF. The observed vs. predicted 18-month survival was 72.1% vs. 72.3% in the derivation cohort and 71.4% vs. 71.2% in the validation cohort. The corresponding values of the c statistic were 0.733 [95% confidence interval (CI) 0.705–0.761] and 0.702 (95% CI 0.663–0.744), respectively. The model's accuracy in predicting HF hospitalization was excellent, with predicted values that closely resembled the values observed in the derivation cohort. <p/>Conclusion: The COACH risk engine accurately predicted survival and various measures of recurrent hospitalization in (acute) HF patients. It may therefore become a valuable tool in improving and personalizing patient care and optimizing the use of scarce healthcare resources.

Item Type:Articles
Additional Information:This is a pre-copy-editing, author-produced PDF of an article accepted for publication in European Journal of Heart Failure following peer review. The definitive publisher-authenticated version European Journal of Heart Failure 14(2):168-175 is available online at: http://dx.doi.org/10.1093/eurjhf/hfr163
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Lewsey, Professor Jim
Authors: Postmus, D., van Veldhuisen, D.J., Jaarsma, T., Luttik, M.L., Lassus, J., Mebazaa, A., Nieminen, M.S., Harjola, V.P., Lewsey, J., Buskens, E., and Hillege, H.L.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment
Journal Name:European Journal of Heart Failure
Publisher:Oxford University Press on behalf of the European Society of Cardiology
ISSN:1388-9842
Published Online:07 December 2011
Copyright Holders:Copyright © 2012 The Authors
First Published:First published in European Journal of Heart Failure 14(2):168-175
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

University Staff: Request a correction | Enlighten Editors: Update this record