Xanthopoulos Andrew, Skoularigis John, Briasoulis Alexandros, Magouliotis Dimitrios E, Zajichek Alex, Milinovich Alex, Kattan Michael W, Triposkiadis Filippos, Starling Randall C
Department of Cardiology, University General Hospital of Larissa, 41110 Larissa, Greece.
Department of Clinical Therapeutics, Faculty of Medicine, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece.
J Pers Med. 2023 Dec 17;13(12):1721. doi: 10.3390/jpm13121721.
Early risk stratification is of outmost clinical importance in hospitalized patients with heart failure (HHF). We examined the predictive value of the Larissa Heart Failure Risk Score (LHFRS) in a large population of HHF patients from the Cleveland Clinic. A total of 13,309 admissions for heart failure (HF) from 9207 unique patients were extracted from the Cleveland Clinic's electronic health record system. For each admission, components of the 3-variable simple LHFRS were obtained, including hypertension history, myocardial infarction history, and red blood cell distribution width (RDW) ≥ 15%. The primary outcome was a HF readmission and/or all-cause mortality at one year, and the secondary outcome was all-cause mortality at one year of discharge. For both outcomes, all variables were statistically significant, and the Kaplan-Meier curves were well-separated and in a consistent order (Log-rank test -value < 0.001). Higher LHFRS values were found to be strongly related to patients experiencing an event, showing a clear association of LHFRS with this study outcomes. The bootstrapped-validated area under the curve (AUC) for the logistic regression model for each outcome revealed a C-index of 0.64 both for the primary and secondary outcomes, respectively. LHFRS is a simple risk model and can be utilized as a basis for risk stratification in patients hospitalized for HF.
早期风险分层对于住院心力衰竭患者（HHF）具有至关重要的临床意义。我们在克利夫兰诊所的大量HHF患者群体中检验了拉里萨心力衰竭风险评分（LHFRS）的预测价值。从克利夫兰诊所的电子健康记录系统中提取了来自9207名独特患者的总共13309次心力衰竭（HF）住院记录。对于每次住院，获取了三变量简单LHFRS的组成部分，包括高血压病史、心肌梗死病史以及红细胞分布宽度（RDW）≥15%。主要结局是一年时的HF再入院和/或全因死亡率，次要结局是出院一年时的全因死亡率。对于这两个结局，所有变量均具有统计学意义，并且Kaplan-Meier曲线区分明显且顺序一致（对数秩检验P值<0.001）。发现较高的LHFRS值与发生事件的患者密切相关，表明LHFRS与本研究结局存在明确关联。每个结局的逻辑回归模型的自展验证曲线下面积（AUC）显示，主要结局和次要结局的C指数分别为0.64。LHFRS是一个简单的风险模型，可作为HF住院患者风险分层的基础。
