PMID- 37128487
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230503
IS  - 2352-0132 (Electronic)
IS  - 2096-6296 (Print)
IS  - 2352-0132 (Linking)
VI  - 10
IP  - 2
DP  - 2023 Apr
TI  - Development and validation of dynamic nomogram of frailty risk for older patients 
      hospitalized with heart failure.
PG  - 142-150
LID - 10.1016/j.ijnss.2023.03.014 [doi]
AB  - OBJECTIVE: This study aimed to establish and validate a dynamic online nomograph 
      for predicting the risk of frailty in older patients hospitalized with heart 
      failure in China. METHODS: A total of 451 older adults with heart failure 
      hospitalized were selected between December 2021 and November 2022 at the 
      Department of Cardiovascular Medicine in a Class A tertiary hospital in Shandong, 
      China. The data of patients were obtained by using Barthel Index, instrumental 
      activity of daily living scale, mini nutrition assessment-short form, Pittsburgh 
      sleep quality index scale, Morse fall risk assessment scale and general 
      information scale. The brain natriuretic peptide and echocardiographic indexes of 
      patients were collected by electronic medical records. All participants were 
      randomly divided into the training set (n = 319) and the validation set (n = 132) 
      at the ratio of 7:3. The training set is used for model construction, and the 
      validation set is used for internal validation. Using the Least Absolute 
      Shrinkage and Selection Operator (LASSO) regression method to filter modeling 
      variables, while the multivariable logistic regression was used to establish the 
      nomogram based on the screened optimal variables. The performance of the model 
      was evaluated by the area under the curve (AUC) of the receiver operator 
      characteristic (ROC) curve, Hosmer-Lemeshow test, calibration plot, and decision 
      curve analysis (DCA). RESULTS: The prevalence of frailty in 451 patients was 
      50.6%, 51.4%, and 48.5% in the training and validation sets, respectively. 
      Drinking, grip strength, New York Heart Association (NYHA) class, multimorbidity, 
      hospitalization history of heart failure, Barthel Index, the instrumental 
      activities of daily living, nutritional status, sleep, fall, and left atrial 
      end-diastolic diameter were used for LASSO regression analysis as the significant 
      predictors of frailty. According to internal validation, the AUC of the ROC curve 
      for the nomogram was 0.920, with a sensitivity of 86.8% and specificity of 84.4%. 
      Moreover, in the validation set, the P-values of the H-L test were 0.742, and the 
      calibration curve had good concordance between the estimated frailty risk and 
      actual observation, indicating the model was well-calibrated. The DCA results 
      confirmed that the nomogram had a well-performance in clinical suitability. 
      CONCLUSIONS: An online dynamic nomogram predicting frailty for older patients 
      hospitalized for heart failure in China was well-established and identified in 
      this study. This model benefits medical professionals in identifying high-risk 
      frailty in older hospitalized patients with heart failure, which could reduce the 
      medical and disease burden of heart failure to a certain extent. However, further 
      verification is needed in the future.
CI  - (c) 2023 The Authors.
FAU - Li, Qian
AU  - Li Q
AD  - School of Nursing, Weifang Medical University, Weifang, China.
FAU - Chen, Yanping
AU  - Chen Y
AD  - Department of Nursing, Weifang People's Hospital, Weifang, China.
FAU - Qin, Dechun
AU  - Qin D
AD  - Department of Nursing, Weifang People's Hospital, Weifang, China.
FAU - Li, Shumei
AU  - Li S
AD  - Department of Anesthesiology, Weifang People's Hospital, Weifang, China.
FAU - Zhang, Shiyu
AU  - Zhang S
AD  - School of Nursing, Weifang Medical University, Weifang, China.
FAU - Fang, Liu
AU  - Fang L
AD  - School of Nursing, Weifang Medical University, Weifang, China.
FAU - Zhu, Jiafeng
AU  - Zhu J
AD  - School of Nursing, Weifang Medical University, Weifang, China.
FAU - Wang, Yingchao
AU  - Wang Y
AD  - School of Nursing, Weifang Medical University, Weifang, China.
FAU - Mao, Yanan
AU  - Mao Y
AD  - School of Nursing, Weifang Medical University, Weifang, China.
FAU - Zhang, Lane
AU  - Zhang L
AD  - School of Nursing, Weifang Medical University, Weifang, China.
LA  - eng
PT  - Journal Article
DEP - 20230323
PL  - China
TA  - Int J Nurs Sci
JT  - International journal of nursing sciences
JID - 101660887
PMC - PMC10148265
OTO - NOTNLM
OT  - Aged
OT  - Frailty
OT  - Heart failure
OT  - Nomogram
OT  - Patients
COIS- The authors have declared no conflict of interest.
EDAT- 2023/05/02 06:42
MHDA- 2023/05/02 06:43
PMCR- 2023/03/23
CRDT- 2023/05/02 01:58
PHST- 2022/12/15 00:00 [received]
PHST- 2023/03/03 00:00 [revised]
PHST- 2023/03/19 00:00 [accepted]
PHST- 2023/05/02 06:43 [medline]
PHST- 2023/05/02 06:42 [pubmed]
PHST- 2023/05/02 01:58 [entrez]
PHST- 2023/03/23 00:00 [pmc-release]
AID - S2352-0132(23)00036-4 [pii]
AID - 10.1016/j.ijnss.2023.03.014 [doi]
PST - epublish
SO  - Int J Nurs Sci. 2023 Mar 23;10(2):142-150. doi: 10.1016/j.ijnss.2023.03.014. 
      eCollection 2023 Apr.