Department of Cardiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 3100016, China.
Department of Cardiology, CHC International Hospital, Cixi, Zhejiang 315310, China.
Chin Med J (Engl). 2022 Dec 5;135(23):2829-2835. doi: 10.1097/CM9.0000000000002026.
The Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) risk score was developed in 2013 to predict survival in heart failure (HF) patients. However, it has yet to be validated in a Chinese population. Our study aimed to investigate the ability of the score to predict 1-year mortality in a Chinese population.
Consecutive patients with HF were retrospectively selected from the inpatient electronic medical records of the cardiology department in a regional hospital in China. A total integer score was calculated for each enrolled patient based on the value of each risk factor in the MAGGIC scoring system. Each enrolled patient was followed for at least 1 year. The observational endpoint of this study was all-cause mortality. The predictive ability of the MAGGIC score was assessed by comparing observed and predicted mortality within 1 year.
Between January 2018 and December 2020, a total of 635 patients were included in the study: 57 (9.0%) of whom died within 1 year after discharge. The average age of all patients was 74.6 ± 11.2 years, 264 of them (41.6%) were male, and the average left ventricular ejection fraction was 50.7% ± 13.2%. The area under the receiver operating characteristic curve was 0.840 (95% confidence interval: 0.779, 0.901), which indicated a fair discriminatory ability of the score. The Hosmer-Lemeshow test result ( χ2 = 12.902, degree of freedom = 8, P = 0.115) indicated that the MAGGIC score had good calibration. The decision curve analysis showed that the MAGGIC score yielded a good clinical net benefit and net reduction in interventions.
This validation of the MAGGIC score showed that it has a good ability to predict 1-year mortality in Chinese patients with HF after discharge. Due to regional and inter-hospital differences, external validation studies need to be further confirmed in other centers.
Meta-Analysis Global Group in Chronic Heart Failure（MAGGIC）风险评分于 2013 年开发，用于预测心力衰竭（HF）患者的生存率。然而，它尚未在中国人群中得到验证。我们的研究旨在探讨该评分在中国人群中预测 1 年死亡率的能力。
连续入选中国某地区医院心内科住院电子病历中的 HF 患者。根据 MAGGIC 评分系统中每个危险因素的值，为每位入组患者计算总整数评分。每位入组患者至少随访 1 年。本研究的观察终点为全因死亡率。通过比较 1 年内观察到的和预测到的死亡率来评估 MAGGIC 评分的预测能力。
2018 年 1 月至 2020 年 12 月，共纳入 635 例患者：出院后 1 年内死亡 57 例（9.0%）。所有患者的平均年龄为 74.6±11.2 岁，264 例（41.6%）为男性，平均左心室射血分数为 50.7%±13.2%。受试者工作特征曲线下面积为 0.840（95%置信区间：0.779，0.901），表明评分具有良好的区分能力。Hosmer-Lemeshow 检验结果（ χ2 = 12.902，自由度 = 8，P = 0.115）表明 MAGGIC 评分具有良好的校准度。决策曲线分析显示，MAGGIC 评分可带来良好的临床净获益和干预净减少。
该 MAGGIC 评分的验证表明，它在中国 HF 出院患者中具有良好的预测 1 年死亡率的能力。由于区域和医院间的差异，需要在其他中心进一步进行外部验证研究。
