Key result
NYHA class III-IV linked to ~146% greater 12-month unplanned hospitalization risk in HF patients.
Why the study?
Heart failure is the leading cause of hospitalization in people over age 65, and predictive models to reduce hospital admissions in primary care patients are needed.
Can a predictive model based on clinical variables predict unplanned hospitalization over 12 months in primary care patients with heart failure?
Cohort (n=251)
Yes
Can a predictive model based on clinical variables predict unplanned hospitalization over 12 months in primary care patients with heart failure?
Odds Ratio: 2.46 (95% CI 1.23–4.91)
p-value: p=0.0108
A simple 4-variable model including NYHA class, diabetes, COPD, and MLHFQ emotional score can predict 12-month unplanned hospitalization in primary care heart failure patients with acceptable discrimination.
BACKGROUND: Heart failure (HF) is the leading cause of hospitalization in people over age 65. Predictive hospital admission models have been developed to help reduce the number of these patients. AIM: To develop and internally validate a model to predict hospital admission in one-year for any non-programmed cause in heart failure patients receiving primary care treatment. DESIGN AND SETTING: Cohort study, prospective. Patients treated in family medicine clinics. METHODS: Logistic regression analysis was used to estimate the association between the predictors and the outcome, i.e. unplanned hospitalization over a 12-month period. The predictive model was built in several steps. The initial examination included a set of 31 predictors. Bootstrapping was used for internal validation. RESULTS: The study included 251 patients, 64 (25.5%) of whom were admitted to hospital for some unplanned cause over the 12 months following their date of inclusion in the study. Four predictive variables of hospitalization were identified: NYHA class III-IV, OR (95% CI) 2.46 (1.23-4.91); diabetes OR (95% CI) 1.94 (1.05-3.58); COPD OR (95% CI) 3.17 (1.45-6.94); MLHFQ Emotional OR (95% CI) 1.07 (1.02-1.12). AUC 0.723; R2N 0.17; Hosmer-Lemeshow 0.815. Internal validation AUC 0.706.; R2N 0.134. CONCLUSION: This is a simple model to predict hospitalization over a 12-month period based on four variables: NYHA functional class, diabetes, COPD and the emotional dimension of the MLHFQ scale. It has an acceptable discriminative capacity enabling the identification of patients at risk of hospitalization.
No takes yet. Share an insight, caveat, or question.
García-Olmos et al. (2019) conducted a cohort in Heart failure (n=251). NYHA class III-IV vs. NYHA class I-II was evaluated on Unplanned hospitalization for any non-programmed cause in 12 months (OR 2.46, 95% CI 1.23-4.91, p=0.0108). NYHA functional class III-IV significantly increased the risk of 12-month unplanned hospitalization (OR 2.46) in primary care patients with heart failure, alongside diabetes, COPD, and emotional score.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: