Heart failureA Novel Prognostic Index to Determine the Impact of Cardiac Conditions and Co-Morbidities on One-Year Outcome in Patients With Heart Failure
Section snippets
Study population
The study population consisted of 807 patients, of whom 292 (the derivation cohort) were consecutively enrolled from January 1, 2003, to April 30, 2003, in 3 different clinical settings and used to develop the CardioVascular Medicine Heart Failure (CVM-HF) index: 139 (48%) at discharge from the hospital, 111 (38%) in the outpatient clinic, and 42 (14%) in the home-care setting. The data from the remaining 515 patients (the validation cohort), enrolled from May to December 2003, were used to
Results
Table 1, Table 2 list the set of candidate predictors of survival at 1 year considered at the beginning of the analysis, subdivided into demographic and clinical predictors. The mean age at recruitment was greater in women than in men (76 ± 14 vs 67 ± 13 years, p <0.0001). Quantitative assessment of systolic ventricular function was available in 252 patients (86%, mean left ventricular ejection fraction 38 ± 13%) of the derivation cohort and in 409 patients (79%, mean left ventricular ejection
Discussion
We developed a model to evaluate the 1-year risk for all-cause mortality from the combination of demographic data, routine biochemistry, co-morbidities, and a few cardiovascular variables and tested it in different clinical settings and in all stages of HF. Our index performed well in the derivation and validation cohorts, with AUC values superior to those previously reported1, 14: score percentiles clearly discriminated prognosis, and the curves started to diverge after the first month of
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