Utility of the SENIORS elderly heart failure riskmodel applied to the RICA registry of acute heart failure

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:182

Article

Montero-Perez-Barquero, Manuel¹  Manzano, Luis²  Formiga, Francesc³  Roughton, Michael⁴  Coats, Andrew^5,6  Rodriguez-Artalejo, Fernando⁷  Diez-Manglano, Jesus⁸  Bettencourt, Paulo⁹  Llacer, Pau¹⁰  Flather, Marcus^11,12 

[1] Univ Cordoba, Dept Internal Med, IMIBIC, Hosp Reina Sofia, E-14071 Cordoba, Spain

[2] Univ Alcala, Ramon & Cajal Univ Hosp, Dept Internal Med, Heart Failure & Vasc Risk Unit, Madrid, Spain

[3] Univ Hosp Bellvitge, Hosp Llobregat, IDIBELL, Geriatr Unit,Internal Med Serv, Barcelona, Spain

[4] R Squared Stat Consultancy, London, England

[5] Monash Univ, Joint Acad Off, Clayton, Vic 3800, Australia

[6] Univ Warwick, Coventry CV4 7AL, W Midlands, England

[7] Univ Autonoma Madrid, Sch Med, Dept Prevent Med & Publ Hlth, IdiPAZ,CIBER Epidemiol & Publ Hlth CIBERESP, Madrid, Spain

[8] Hosp Royo Villanova, Dept Internal Med, Zaragoza, Spain

[9] Hosp Sao Joao, Dept Internal Med, Oporto, Portugal

[10] Hosp Manises, Dept Internal Med, Valencia, Spain

[11] Univ E Anglia, Norwich Med Sch, Norfolk, VA USA

[12] Norwich Univ Hosp, Norwich, Norfolk, England

关键词: Heart failure;    Mortality;    Morbidity;    Risk score;   

DOI  :  10.1016/j.ijcard.2014.12.173

来源: Elsevier

【 摘 要 】

Background: Heart failure (HF) is predominantly a disease of the elderly. Reliable risk stratification would help in the management of this population, but no model has been well evaluated in elderly HF patients in both acute and chronic settings and not being restricted by ejection fraction. To evaluate the utility of the SENIORS risk model, developed from a clinical trial of elderly patients with chronic HF, in an independent cohort (National Spanish Registry: RICA) of elderly acute HF patients. Methods: We applied the SENIORS riskmodel to 926 patients in RICA to estimate risk at one year of a) composite outcome of all-cause mortality or cardiovascular hospital admission and b) all-cause mortality. Results: In the RICA registrymean age was 78 years, mean ejection fraction 51% and 87% were in NYHA II and III. At one year death/CV hospitalization occurred in 31.9% and all-causemortality in 19.5%. The riskmodel provided good separation of Kaplan Meier curves stratified by tertile for death/CV hospitalization and all-cause mortality. The observed versus expected rates of death/CV hospitalization in the lowest, middle and highest risk tertiles were (%) 34/24, 45/41 and 57/67, and for death 13/16, 32/38 and 44/70 respectively. C-statistic for all-causemortality or CV hospitalization was 0.60 and for all-cause mortality 0.66. Conclusion: The SENIORS risk model was a reliable tool for relative risk stratification among acute heart failure patients in a real world registry, but predicted versus observed risk showed some variability. The model provides a useful basis for clinical risk prediction. (C) 2015 The Authors. Published by Elsevier Ireland Ltd.

【 授权许可】

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