Prognostic value of patient‐reported outcomes in predicting 30 day all‐cause readmission among older patients with heart failure
Abstract Aims Previous prediction studies for 30 day readmission in patients with heart failure were built mainly based on electronic medical records and rarely involved patient‐reported outcomes. This study aims to develop and validate a nomogram including patient‐reported outcomes to predict the p...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-10-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.13991 |
| _version_ | 1827915443273203712 |
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| author | Xiaonan Zhang Ying Yao Yanwen Zhang Sixuan Jiang Xuedong Li Xiaobing Wang Yanting Li Weiling Yang Yue Zhao Xiaoying Zang |
| author_facet | Xiaonan Zhang Ying Yao Yanwen Zhang Sixuan Jiang Xuedong Li Xiaobing Wang Yanting Li Weiling Yang Yue Zhao Xiaoying Zang |
| author_sort | Xiaonan Zhang |
| collection | DOAJ |
| description | Abstract Aims Previous prediction studies for 30 day readmission in patients with heart failure were built mainly based on electronic medical records and rarely involved patient‐reported outcomes. This study aims to develop and validate a nomogram including patient‐reported outcomes to predict the possibility of 30 day all‐cause readmission in older patients with heart failure and to explore the value of patient‐reported outcomes in prediction model. Methods and results This was a prospective cohort study. The nomogram was developed and internally validated by Logistic regression analysis based on 381 patients in training group from March to December 2019. The nomogram was externally validated based on 170 patients from July to October 2020. Receiver operating characteristic curves, calibration plots and decision‐curve analysis were used to evaluate the performance of the nomogram. A total of 381 patients' complete data were analysed in the training group and 170 patients were enrolled in the external validation group. In the training group, 14.4% (n = 55) patients were readmitted to hospitals within 30 days of discharge and 15.9% (n = 27) patients were readmitted in the external validation group. The nomogram included six factors: history of surgery, changing the type of medicine by oneself, information acquisition ability, subjective support, depression level, quality of life, all of which were significantly associated with 30 day readmission in older patients with heart failure. The areas under the receiver operating characteristic curves of nomogram were 0.949 (95% CI: 0.925, 0.973, sensitivity: 0.873, specificity: 0.883) and 0.804 (95% CI: 0.691, 0.917, sensitivity: 0.778, specificity: 0.832) respectively in the training and external validation groups, which indicated that the nomogram had better discrimination ability. The calibration plots demonstrated favourable coordination between predictive probability of 30 day readmission and observed probability. Decision‐curve analysis showed that the net benefit of the nomogram was better between threshold probabilities of 0–85%. Conclusions A novel and easy‐to‐use nomogram is constructed and demonstrated which emphasizes the important role of patient‐reported outcomes in predicting studies. The performance of the nomogram drops in the external validation cohort and the nomogram must be validated in a wide prospective cohort of HF patients before its clinical relevance can be demonstrated. All these findings in this study can assist professionals in identifying the needs of HF patients so as to reduce 30 day readmission. |
| first_indexed | 2024-03-13T03:00:33Z |
| format | Article |
| id | doaj.art-68a4878d712b463bac6344f4d363691f |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-03-13T03:00:33Z |
| publishDate | 2022-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-68a4878d712b463bac6344f4d363691f2023-06-27T14:49:57ZengWileyESC Heart Failure2055-58222022-10-01952840285010.1002/ehf2.13991Prognostic value of patient‐reported outcomes in predicting 30 day all‐cause readmission among older patients with heart failureXiaonan Zhang0Ying Yao1Yanwen Zhang2Sixuan Jiang3Xuedong Li4Xiaobing Wang5Yanting Li6Weiling Yang7Yue Zhao8Xiaoying Zang9School of Nursing Tianjin Medical University Tianjin ChinaDepartment of Emergency Tianjin Medical University General Hospital Tianjin ChinaSchool of Nursing Tianjin Medical University Tianjin ChinaSchool of Nursing Tianjin Medical University Tianjin ChinaSchool of Nursing Tianjin Medical University Tianjin ChinaSchool of Nursing Tianjin Medical University Tianjin ChinaSchool of Nursing Tianjin Medical University Tianjin ChinaSchool of Nursing Tianjin Medical University Tianjin ChinaSchool of Nursing Tianjin Medical University Tianjin ChinaSchool of Nursing Tianjin Medical University Tianjin ChinaAbstract Aims Previous prediction studies for 30 day readmission in patients with heart failure were built mainly based on electronic medical records and rarely involved patient‐reported outcomes. This study aims to develop and validate a nomogram including patient‐reported outcomes to predict the possibility of 30 day all‐cause readmission in older patients with heart failure and to explore the value of patient‐reported outcomes in prediction model. Methods and results This was a prospective cohort study. The nomogram was developed and internally validated by Logistic regression analysis based on 381 patients in training group from March to December 2019. The nomogram was externally validated based on 170 patients from July to October 2020. Receiver operating characteristic curves, calibration plots and decision‐curve analysis were used to evaluate the performance of the nomogram. A total of 381 patients' complete data were analysed in the training group and 170 patients were enrolled in the external validation group. In the training group, 14.4% (n = 55) patients were readmitted to hospitals within 30 days of discharge and 15.9% (n = 27) patients were readmitted in the external validation group. The nomogram included six factors: history of surgery, changing the type of medicine by oneself, information acquisition ability, subjective support, depression level, quality of life, all of which were significantly associated with 30 day readmission in older patients with heart failure. The areas under the receiver operating characteristic curves of nomogram were 0.949 (95% CI: 0.925, 0.973, sensitivity: 0.873, specificity: 0.883) and 0.804 (95% CI: 0.691, 0.917, sensitivity: 0.778, specificity: 0.832) respectively in the training and external validation groups, which indicated that the nomogram had better discrimination ability. The calibration plots demonstrated favourable coordination between predictive probability of 30 day readmission and observed probability. Decision‐curve analysis showed that the net benefit of the nomogram was better between threshold probabilities of 0–85%. Conclusions A novel and easy‐to‐use nomogram is constructed and demonstrated which emphasizes the important role of patient‐reported outcomes in predicting studies. The performance of the nomogram drops in the external validation cohort and the nomogram must be validated in a wide prospective cohort of HF patients before its clinical relevance can be demonstrated. All these findings in this study can assist professionals in identifying the needs of HF patients so as to reduce 30 day readmission.https://doi.org/10.1002/ehf2.13991NomogramPatient‐reported outcomesReadmissionHeart failure; older adult |
| spellingShingle | Xiaonan Zhang Ying Yao Yanwen Zhang Sixuan Jiang Xuedong Li Xiaobing Wang Yanting Li Weiling Yang Yue Zhao Xiaoying Zang Prognostic value of patient‐reported outcomes in predicting 30 day all‐cause readmission among older patients with heart failure ESC Heart Failure Nomogram Patient‐reported outcomes Readmission Heart failure; older adult |
| title | Prognostic value of patient‐reported outcomes in predicting 30 day all‐cause readmission among older patients with heart failure |
| title_full | Prognostic value of patient‐reported outcomes in predicting 30 day all‐cause readmission among older patients with heart failure |
| title_fullStr | Prognostic value of patient‐reported outcomes in predicting 30 day all‐cause readmission among older patients with heart failure |
| title_full_unstemmed | Prognostic value of patient‐reported outcomes in predicting 30 day all‐cause readmission among older patients with heart failure |
| title_short | Prognostic value of patient‐reported outcomes in predicting 30 day all‐cause readmission among older patients with heart failure |
| title_sort | prognostic value of patient reported outcomes in predicting 30 day all cause readmission among older patients with heart failure |
| topic | Nomogram Patient‐reported outcomes Readmission Heart failure; older adult |
| url | https://doi.org/10.1002/ehf2.13991 |
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