Key result
A 13-parameter clinical nomogram predicted 30-day all-cause readmission in heart failure patients with an area under the ROC curve of 0.653 (95% CI 0.608-0.698).
Why the study?
Heart failure readmission within 30 days of discharge is a challenging public health issue, and predicting readmission risk may help clinicians develop individualized treatment plans.
Can a nomogram based on 13 clinical parameters accurately predict 30-day all-cause readmission in patients with heart failure?
Observational (n=2,254)
Can a nomogram based on 13 clinical parameters accurately predict 30-day all-cause readmission in patients with heart failure?
Effect estimate: AUC 0.653 (95% CI 0.608-0.698)
A 13-variable clinical nomogram provides modest discrimination (AUC 0.653) for predicting 30-day all-cause readmission in patients with heart failure, potentially aiding in individualized discharge planning.
May aid HF readmission risk stratification at discharge; leaves open external validation before clinical adoption.
Background: Readmission within 30 days of discharge for heart failure (HF) has become a challenging public health issue. Predicting the risk of 30-day readmission may assist clinicians in making individualized treatment plans for HF patients. Methods: A total of 2254 patients were enrolled in this study. The risk predictors associated with 30-day readmission were selected using the least absolute shrinkage and the selection operator regression model. The performance of the nomogram was evaluated using the receiver operating characteristic (ROC) curve, Hosmer–Lemeshow (HL) test, and decision curve analysis (DCA). Results: The 30-day all-cause readmission rate was 7.1%. Thirteen clinical parameters were identified as the risk predictors, including age, cystatin C, albumin, red cell distribution width coefficient variation, neutrophils, N-terminal pro-B-type natriuretic peptide, high-sensitivity cardiac troponin T, myoglobin, sex, dyslipidaemia, left ventricular ejection fraction, left ventricular end-diastolic dimension, and atrial fibrillation. The nomogram showed good discrimination, with an area under the ROC curve of 0.653 (95% confidence interval: 0.608–0.698) and good calibration results (HL test p = 0.328). The DCA showed that the nomogram would have good clinical utility. Conclusions: This predictive model based on clinical data makes it simple for clinicians to assess the 30-day HF readmission risk.
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Hu et al. (2022) conducted an observational in Heart failure (n=2,254). 13-parameter clinical nomogram was evaluated on 30-day all-cause readmission (AUC 0.653, 95% CI 0.608-0.698). A 13-parameter clinical nomogram predicted 30-day all-cause readmission in heart failure patients with an area under the ROC curve of 0.653 (95% CI 0.608-0.698).
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