PMID- 12748212
OWN - NLM
STAT- MEDLINE
DCOM- 20030612
LR  - 20220408
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Print)
IS  - 1355-6037 (Linking)
VI  - 89
IP  - 6
DP  - 2003 Jun
TI  - Predicting mortality in patients with heart failure: a pragmatic approach.
PG  - 605-9
AB  - OBJECTIVE: To develop a comprehensive and easily applicable prognostic model 
      predicting mortality risk in patients with moderate to severe heart failure. 
      DESIGN: Prospective follow up study. SETTING: Seven general hospitals in the 
      Netherlands. PATIENTS: 152 outpatients with heart failure or patients admitted to 
      hospital because of heart failure, who were included in a randomised trial to 
      assess the impact of a pharmacist led intervention to improve drug compliance. 
      Duration of follow up was at least 18 months. MAIN OUTCOME MEASURES: 
      Multivariable logistic regression modelling was used to evaluate information from 
      history, physical examination (for example, blood pressure), drug use, and 
      quality of life questionnaires that independently contributed to the prediction 
      of death. The area under receiver operating characteristic curves (AUC) was used 
      to estimate the predictive ability of the prognostic models. RESULTS: During the 
      18 months of follow up, 51 patients (34%) died. Independent predictors of 
      mortality were diabetes mellitus, a history of renal dysfunction (or higher 
      creatinine), New York Heart Association (NYHA) functional class III or IV, lower 
      weight or body mass index, lower blood pressure, ankle oedema, and higher scores 
      on a disease specific quality of life questionnaire. The use of beta blockers was 
      predictive of a better prognosis. These factors were used to derive various 
      prediction formulas. A model based on medical history, weight, presence of 
      oedema, and lower blood pressure had an AUC of 0.77. Addition of use of beta 
      blockers to this model improved the AUC to 0.80. Addition of NYHA class increased 
      the AUC to 0.84. Data on quality of life did not improve the AUC further (AUC 
      0.85). CONCLUSIONS: A prognostic model produced on the basis of easily obtainable 
      information from medical history and physical examination can adequately stratify 
      heart failure patients according to their short term risk of death.
FAU - Bouvy, M L
AU  - Bouvy ML
AD  - Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for 
      Pharmaceutical Sciences, Utrecht, Netherlands. m.bouvy@pharm.uu.nl
FAU - Heerdink, E R
AU  - Heerdink ER
FAU - Leufkens, H G M
AU  - Leufkens HG
FAU - Hoes, A W
AU  - Hoes AW
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
CIN - Heart. 2003 Jun;89(6):587-8. PMID: 12748203
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Area Under Curve
MH  - Cardiac Output, Low/*mortality
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Netherlands/epidemiology
MH  - Prospective Studies
MH  - Regression Analysis
MH  - Risk Factors
PMC - PMC1767685
EDAT- 2003/05/16 05:00
MHDA- 2003/06/13 05:00
PMCR- 2006/06/01
CRDT- 2003/05/16 05:00
PHST- 2003/05/16 05:00 [pubmed]
PHST- 2003/06/13 05:00 [medline]
PHST- 2003/05/16 05:00 [entrez]
PHST- 2006/06/01 00:00 [pmc-release]
AID - 0890605 [pii]
AID - 10.1136/heart.89.6.605 [doi]
PST - ppublish
SO  - Heart. 2003 Jun;89(6):605-9. doi: 10.1136/heart.89.6.605.