Derivation and validation of a two‐variable index to predict 30‐day outcomes following heart failure hospitalization
| Autor: | Urun Erbas Oz, Tauben Averbuch, Stuart J. Connolly, Harriette G.C. Van Spall, Richard Perez, Shun Fu Lee, Mamas A. Mamas, Dennis T. Ko |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Index (economics) Aftercare 030204 cardiovascular system & hematology Patient Readmission 03 medical and health sciences 0302 clinical medicine RA0421 Internal medicine Original Research Articles medicine Diseases of the circulatory (Cardiovascular) system Humans 030212 general & internal medicine Derivation Original Research Article Care Transitions Aged Retrospective Studies Heart Failure business.industry External validation Regression analysis Length of Stay RC666 medicine.disease Derivation cohort Risk prediction Patient Discharge Heart failure RC666-701 Cohort Cardiology and Cardiovascular Medicine business Emergency Service Hospital RA Readmission |
| Zdroj: | ESC Heart Failure ESC Heart Failure, Vol 8, Iss 4, Pp 2690-2697 (2021) |
| ISSN: | 2055-5822 |
| Popis: | Background\ud The LACE index—length of stay (L), acuity (A), Charlson co-morbidities (C), and emergent visits (E)—predicts 30-day outcomes following heart failure (HF) hospitalization but is complex to score. A simpler LE index (length of stay and emergent visits) could offer a practical advantage in point-of-care risk prediction.\ud \ud Methods and results\ud This was a sub-study of the patient-centred care transitions in HF (PACT-HF) multicentre trial. The derivation cohort comprised patients hospitalized for HF, enrolled in the trial, and followed prospectively. External validation was performed retrospectively in a cohort of patients hospitalized for HF. We used log-binomial regression models with LACE or LE as the predictor and either 30-day composite all-cause readmission or death or 30-day all-cause readmission as the outcomes, adjusting only for post-discharge services. There were 1985 patients (mean [SD] age 78.1 [12.1] years) in the derivation cohort and 378 (mean [SD] age 73.1 [13.2] years) in the validation cohort. Increments in the LACE and LE indices were associated with 17% (RR 1.17; 95% CI 1.12, 1.21; C-statistic 0.64) and 21% (RR 1.21; 95% CI 1.15, 1.26; C-statistic 0.63) increases, respectively, in 30-day composite all-cause readmission or death; and 16% (RR 1.16; 95% CI 1.11, 1.20; C-statistic 0.64) and 18% (RR 1.18; 95% CI 1.13, 1.24; C-statistic 0.62) increases, respectively, in 30-day all-cause readmission. The LE index provided better risk discrimination for the 30-day outcomes than did the LACE index in the external validation cohort.\ud \ud Conclusions\ud The LE index predicts 30-day outcomes following HF hospitalization with similar or better performance than the more complex LACE index. |
| Databáze: | OpenAIRE |
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