The Seattle Heart Failure Model: prediction of survival in heart failure

Autor: Stefan D. Anker, Wayne C. Levy, Mark D. Sullivan, Douglas L. Mann, Dariush Mozaffarian, David T. Linker, Santosh C. Sutradhar, Aldo P. Maggioni, Philip A. Poole-Wilson, Anne B. Cropp, Paul B. J. Burton, Bertram Pitt, Milton Packer, Inder S. Anand
Rok vydání: 2006
Předmět:
Male
Heart disease
Comorbidity
Cohort Studies
Hemoglobins
Ventricular Dysfunction
Left
Prospective Studies
Diuretics
Randomized Controlled Trials as Topic
Aged
80 and over
Hazard ratio
Cardiac Pacing
Artificial
Models
Cardiovascular
Middle Aged
Combined Modality Therapy
Defibrillators
Implantable
Survival Rate
Treatment Outcome
Area Under Curve
Cardiology
Female
Cardiology and Cardiovascular Medicine
Cohort study
Adult
medicine.medical_specialty
Life Expectancy
Physiology (medical)
Internal medicine
medicine
Humans
Lymphocyte Count
Survival rate
Survival analysis
Aged
Proportional Hazards Models
Heart Failure
Proportional hazards model
business.industry
Cardiovascular Agents
medicine.disease
Survival Analysis
Surgery
ROC Curve
Heart failure
Cardiovascular agent
Multivariate Analysis
Heart-Assist Devices
business
Follow-Up Studies
Forecasting
Zdroj: Circulation. 113(11)
ISSN: 1524-4539
Popis: Background— Heart failure has an annual mortality rate ranging from 5% to 75%. The purpose of the study was to develop and validate a multivariate risk model to predict 1-, 2-, and 3-year survival in heart failure patients with the use of easily obtainable characteristics relating to clinical status, therapy (pharmacological as well as devices), and laboratory parameters. Methods and Results— The Seattle Heart Failure Model was derived in a cohort of 1125 heart failure patients with the use of a multivariate Cox model. For medications and devices not available in the derivation database, hazard ratios were estimated from published literature. The model was prospectively validated in 5 additional cohorts totaling 9942 heart failure patients and 17 307 person-years of follow-up. The accuracy of the model was excellent, with predicted versus actual 1-year survival rates of 73.4% versus 74.3% in the derivation cohort and 90.5% versus 88.5%, 86.5% versus 86.5%, 83.8% versus 83.3%, 90.9% versus 91.0%, and 89.6% versus 86.7% in the 5 validation cohorts. For the lowest score, the 2-year survival was 92.8% compared with 88.7%, 77.8%, 58.1%, 29.5%, and 10.8% for scores of 0, 1, 2, 3, and 4, respectively. The overall receiver operating characteristic area under the curve was 0.729 (95% CI, 0.714 to 0.744). The model also allowed estimation of the benefit of adding medications or devices to an individual patient’s therapeutic regimen. Conclusions— The Seattle Heart Failure Model provides an accurate estimate of 1-, 2-, and 3-year survival with the use of easily obtained clinical, pharmacological, device, and laboratory characteristics.
Databáze: OpenAIRE
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