Department of Cardiology, Faculty of Medicine, Medipol University, Istanbul, Turkey.
Department of Biostatistics, Faculty of Medicine, Hatay 52987Mustafa Kemal University, Hatay, Turkey.
Angiology. 2020 Nov;71(10):948-954. doi: 10.1177/0003319720941758. Epub 2020 Jul 24.
We aimed to predict in-hospital mortality of elderly patients with heart failure (HF) by using a risk score model which could be easily applied in routine clinical practice without using an electronic calculator. The study population (n = 1034) recruited from the Journey HF-TR (Patient Journey in Hospital with Heart Failure in Turkish Population) study was divided into a derivation and a validation cohort. The parameters related to in-hospital mortality were first analyzed by univariate analysis, then the variables found to be significant in that analysis were entered into a stepwise multivariate logistic regression (LR) analysis. Patients were classified as low, intermediate, and high risk. A risk score obtained by taking into account the regression coefficients of the significant variables as a result of the LR analysis was tested in the validation cohort using receiver operating characteristic curve analysis. In total, 6 independent variables (age, blood urea nitrogen, previous history of hemodialysis/hemofiltration, inotropic agent use, and length of intensive care stay) associated with in-hospital mortality were included in the analysis. The risk score had a good discrimination in both the derivation and validation cohorts. A new validated risk score to determine the risk of in-hospital mortality of elderly hospitalized patients with HF was developed by including 6 independent predictors.
我们旨在通过使用风险评分模型来预测老年心力衰竭(HF)患者的住院死亡率,该模型无需使用电子计算器即可在常规临床实践中轻松应用。从 Journey HF-TR(土耳其人群心力衰竭住院患者的旅程)研究中招募的研究人群(n=1034)被分为推导队列和验证队列。首先通过单因素分析对与住院死亡率相关的参数进行分析,然后将在该分析中发现有意义的变量纳入逐步多变量逻辑回归(LR)分析。患者被分为低危、中危和高危。通过考虑 LR 分析中显著变量的回归系数获得的风险评分,使用验证队列中的接收者操作特征曲线分析进行测试。共有 6 个独立变量(年龄、血尿素氮、既往血液透析/血液滤过史、正性肌力药物使用和重症监护病房住院时间)与住院死亡率相关,被纳入分析。风险评分在推导和验证队列中均具有良好的区分度。通过纳入 6 个独立预测因素,开发了一种新的经过验证的风险评分,用于确定老年住院 HF 患者住院死亡率的风险。