November 1, 2017Open Access

Prediction model of in-hospital mortality in elderly patients with acute heart failure based on retrospective study.

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Why the study?

Does the RPSS model accurately predict in-hospital mortality in elderly patients with acute heart failure compared to the GWTG-HF score?

Structured PICO

Does the RPSS model accurately predict in-hospital mortality in elderly patients with acute heart failure compared to the GWTG-HF score?

Population

2,431 patients aged 60 years and older hospitalized with acute heart failure (AHF) in intensive care units of the Cardiology Department at the Chinese PLA General Hospital.

Intervention

Risk Prediction Score System (RPSS) based on heart rate, left ventricular ejection fraction, pH value, estimated glomerular filtration rate, and NT-pro BNP

Comparator

Get With The Guidelines-Heart Failure (GWTG-HF) risk score

Outcome

In-hospital mortalityhard clinical

A novel risk prediction score system incorporating heart rate, LVEF, pH, eGFR, and NT-proBNP accurately predicts in-hospital mortality in elderly patients with acute heart failure, outperforming the established GWTG-HF score.

Limitations

Single-center, retrospective control study
Rather small population
Reports in-hospital mortality only and was not validated for post-discharge outcomes
Linear terms might not be appropriate for predictors with non-linear associations

Implication

May aid elderly AHF risk stratification; leaves open prospective validation before clinical adoption.

Abstract

OBJECTIVES: The aim of this study was to develop a clinical risk model that is predictive of in-hospital mortality in elderly patients hospitalized with acute heart failure (AHF). METHODS: 2486 patients who were 60 years and older from intensive care units of Cardiology Department in the hospital were analyzed. Independent risk factors for in-hospital mortality were obtained by binary logistic regression and then used to establish the risk prediction score system (RPSS). The area under the curve (AUC) of receiver operator characteristic and C-statistic test were adopted to assess the performance of RPSS and to compare with previous get with the guidelines-heart failure (GWTG-HF). RESULTS: = 0.016). CONCLUSIONS: Our risk prediction model, RPSS, provided a good prediction for in-hospital mortality in elderly patients with AHF.