A simple validated method for predicting the risk of hospitalization for worsening of heart failure in ambulatory patients: The Redin-SCORE

Jesús Álvarez-García, Andreu Ferrero-Gregori, Teresa Puig, Rafael Vázquez, Juan Delgado, Domingo Pascual-Figal, Luis Alonso-Pulpõn, José R. González-Juanatey, Miguel Rivera, Fernando Worner, Alfredo Bardají, Juan Cinca

Research output: Contribution to journalArticleResearchpeer-review

25 Citations (Scopus)

Abstract

© 2015 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. Aims Prevention of hospital readmissions is one of the main objectives in the management of patients with heart failure (HF). Most of the models predicting readmissions are based on data extracted from hospitalized patients rather than from outpatients. Our objective was to develop a validated score predicting 1-month and 1-year risk of readmission for worsening of HF in ambulatory patients. Methods and results A cohort of 2507 ambulatory patients with chronic HF was prospectively followed for a median of 3.3 years. Clinical, echocardiographic, ECG, and biochemical variables were used in a competing risk regression analysis to construct a risk score for readmissions due to worsening of HF. Thereafter, the score was externally validated using a different cohort of 992 patients with chronic HF (MUSIC registry). Predictors of 1-month readmission were the presence of elevated natriuretic peptides, left ventricular (LV) HF signs, and estimated glomerular filtration rate (eGFR) <60 mL/min/m2. Predictors of 1-year readmission were elevated natriuretic peptides, anaemia, left atrial size >26 mm/m2, heart rate >70 b.p.m., LV HF signs, and eGFR <60 mL/min/m2. The C-statistics for the models were 0.72 and 0.66, respectively. The cumulative incidence function distinguished low-risk (<1% event rate) and high-risk groups (>5% event rate) for 1-month HF readmission. Likewise, low-risk (7.8%), intermediate-risk (15.6%) and high-risk groups (26.1%) were identified for 1-year HF readmission risk. The C-statistics remained consistent after the external validation (<5% loss of discrimination). Conclusion The Redin-SCORE predicts early and late readmission for worsening of HF using proven prognostic variables that are routinely collected in outpatient management of chronic HF.
Original languageEnglish
Pages (from-to)818-827
JournalEuropean Journal of Heart Failure
Volume17
Issue number8
DOIs
Publication statusPublished - 1 Aug 2015

Keywords

  • Competing risk
  • Death
  • Heart failure
  • Readmission
  • Score

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