PMID- 22422744
OWN - NLM
STAT- MEDLINE
DCOM- 20120522
LR  - 20201216
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 98
IP  - 7
DP  - 2012 Apr
TI  - Identifying community based chronic heart failure patients in the last year of 
      life: a comparison of the Gold Standards Framework Prognostic Indicator Guide and 
      the Seattle Heart Failure Model.
PG  - 579-83
LID - 10.1136/heartjnl-2011-301021 [doi]
AB  - OBJECTIVE: To assess the clinical utility of the Gold Standards Framework 
      Prognostic Indicator Guide (GSF) and the Seattle Heart Failure Model (SHF) to 
      identify patients with chronic heart failure (CHF) in the last year of life. 
      DESIGN, SETTING AND PATIENTS: An observational cohort study of 138 community 
      based ambulatory patients with New York Heart Association (NYHA) class III and IV 
      CHF managed by a specialist heart failure nursing team. MAIN OUTCOME MEASURES: 12 
      month mortality, and sensitivity and specificity of GSF and SHF. RESULTS: 138 CHF 
      patients with NYHA class III and IV symptoms were identified from a population of 
      368 ambulatory CHF patients. 119 (86%) met GSF criteria for end of life care. The 
      SHF model identified six (4.3%) patients with a predicted life expectancy of 1 
      year or less. At the 12 month follow-up, 43 (31%) patients had died. The 
      sensitivity and specificity for GSF and SHF in predicting death were 83% and 22%, 
      and 12% and 99%, respectively. Receiver operator characteristic analysis of SHF 
      revealed a C index of 0.68+/-0.05 (95% CI 0.58 to 0.77). Chronic kidney disease 
      (serum creatinine >/=140 mumol/l) was a strong univariate predictor of 12 month 
      mortality, with a sensitivity of 56% and specificity of 72%. CONCLUSIONS: Neither 
      the GSF nor the SHF accurately predicted which patients were in the last year of 
      life. The poor prognostic ability of these models highlights one of the barriers 
      to providing timely palliative care in CHF.
FAU - Haga, Kristin
AU  - Haga K
AD  - Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, UK.
FAU - Murray, Scott
AU  - Murray S
FAU - Reid, Janet
AU  - Reid J
FAU - Ness, Andrea
AU  - Ness A
FAU - O'Donnell, Maureen
AU  - O'Donnell M
FAU - Yellowlees, Diane
AU  - Yellowlees D
FAU - Denvir, Martin A
AU  - Denvir MA
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
CIN - Heart. 2012 Apr;98(7):523-4. PMID: 22422741
CIN - Heart. 2012 Oct;98(20):1538; author reply 1538. PMID: 22914534
MH  - Age Factors
MH  - Aged
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/diagnosis/*epidemiology
MH  - Humans
MH  - Incidence
MH  - *Life Expectancy
MH  - Male
MH  - Population Surveillance/*methods
MH  - Prognosis
MH  - ROC Curve
MH  - Survival Rate/trends
MH  - Time Factors
MH  - Washington/epidemiology
EDAT- 2012/03/17 06:00
MHDA- 2012/05/23 06:00
CRDT- 2012/03/17 06:00
PHST- 2012/03/17 06:00 [entrez]
PHST- 2012/03/17 06:00 [pubmed]
PHST- 2012/05/23 06:00 [medline]
AID - heartjnl-2011-301021 [pii]
AID - 10.1136/heartjnl-2011-301021 [doi]
PST - ppublish
SO  - Heart. 2012 Apr;98(7):579-83. doi: 10.1136/heartjnl-2011-301021.