Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 South XinJian Road, Taiyuan, 030001, Shanxi Province, China.
Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment, 56 South XinJian Road, Taiyuan, 030001, Shanxi Province, China.
Health Qual Life Outcomes. 2020 Aug 27;18(1):290. doi: 10.1186/s12955-020-01534-6.
Health-related quality of life, as evaluated by a patient-reported outcomes measure (PROM), is an important prognostic marker in patients with chronic heart failure. This study aimed to use PROM to establish an effective readmission nomogram for chronic heart failure.
Using a PROM as a measurement tool, we conducted a readmission nomogram for chronic heart failure on a prospective observational study comprising of 454 patients with chronic heart failure hospitalized between May 2017 to January 2020. A Concordance index and calibration curve were used to evaluate the discriminative ability and predictive accuracy of the nomogram. A bootstrap resampling method was used for internal validation of results.
The median follow-up period in the study was 372 days. After a final COX regression analysis, the gender, income, health care, appetite-sleep, anxiety, depression, paranoia, support, and independence were identified and included in the nomogram. The nomogram showed moderate discrimination, with a concordance index of 0.737 (95% CI 0.673-0.800). The calibration curves for the probability of readmission for patients with chronic heart failure showed high consistency between the probability, as predicted, and the actual probability.
This model offers a platform to assess the risk of readmission for different populations with CHF and can assist clinicians with personalized treatment recommendations.
健康相关的生活质量，通过患者报告的结果测量（PROM）进行评估，是慢性心力衰竭患者的一个重要预后标志物。本研究旨在使用 PROM 为慢性心力衰竭建立有效的再入院列线图。
我们使用 PROM 作为测量工具，对 2017 年 5 月至 2020 年 1 月期间住院的 454 例慢性心力衰竭患者进行前瞻性观察性研究，以建立慢性心力衰竭再入院列线图。采用一致性指数和校准曲线评估列线图的判别能力和预测准确性。采用自举重采样方法对内部分数进行验证。
本研究的中位随访期为 372 天。最终 COX 回归分析后，确定了性别、收入、医疗保健、食欲-睡眠、焦虑、抑郁、偏执、支持和独立性，并将其纳入列线图。列线图显示出中等的判别能力，一致性指数为 0.737（95%CI 0.673-0.800）。慢性心力衰竭患者再入院概率的校准曲线显示，预测概率与实际概率之间具有高度一致性。
该模型为评估不同 CHF 人群的再入院风险提供了一个平台，并可以为临床医生提供个性化的治疗建议。
