A new scoring system for predicting short‐term outcomes in Chinese patients with critically‐ill acute decompensated heart failure
Abstract Background Acute decompensated heart failure (ADHF) contributes millions of emergency department (ED) visits and it is associated with high in-hospital mortality. The aim of this study was to develop and validate a multiparametric score for critically-ill ADHF patients. Methods In this sing...
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| Language: | English |
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BMC
2021-05-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-021-02041-2 |
| _version_ | 1818779184510533632 |
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| author | Ran Mo Li-tian Yu Hui-qiong Tan Yang Wang Yan-min Yang Yan Liang Jun Zhu |
| author_facet | Ran Mo Li-tian Yu Hui-qiong Tan Yang Wang Yan-min Yang Yan Liang Jun Zhu |
| author_sort | Ran Mo |
| collection | DOAJ |
| description | Abstract Background Acute decompensated heart failure (ADHF) contributes millions of emergency department (ED) visits and it is associated with high in-hospital mortality. The aim of this study was to develop and validate a multiparametric score for critically-ill ADHF patients. Methods In this single-center, retrospective study, a total of 1268 ADHF patients in China were enrolled and divided into derivation (n = 1014) and validation (n = 254) cohorts. The primary endpoint was any in-hospital death, cardiac arrest or utilization of mechanical support devices. Logistic regression model was preformed to identify risk factors and build the new scoring system. The assigning point of each parameter was determined according to its β coefficient. The discrimination was validated internally using C statistic and calibration was evaluated by the Hosmer-Lemeshow goodness-of-fit test. Results We constructed a predictive score based on six significant risk factors [systolic blood pressure (SBP), white blood cell (WBC) count, hematocrit (HCT), total bilirubin (TBIL), estimated glomerular filtration rate (eGFR) and NT-proBNP]. This new model was computed as (1 × SBP < 90 mmHg) + (2 × WBC > 9.2 × 109/L) + (1 × HCT ≤ 0.407) + (2 × TBIL > 34.2 μmol/L) + (2 × eGFR < 15 ml/min/1.73 m2) + (1 × NTproBNP ≥ 10728.9 ng/ml). The C statistic for the new score was 0.758 (95% CI 0.667–0.838) higher than APACHE II, AHEAD and ADHERE score. It also demonstrated good calibration for detecting high-risk patients in the validation cohort (χ2 = 6.681, p = 0.463). Conclusions The new score including SBP, WBC, HCT, TBIL, eGFR and NT-proBNP might be used to predict short-term prognosis of Chinese critically-ill ADHF patients. |
| first_indexed | 2024-12-18T11:56:35Z |
| format | Article |
| id | doaj.art-875985e5d5074e4fa84b90126229a5de |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-18T11:56:35Z |
| publishDate | 2021-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-875985e5d5074e4fa84b90126229a5de2022-12-21T21:09:03ZengBMCBMC Cardiovascular Disorders1471-22612021-05-0121111110.1186/s12872-021-02041-2A new scoring system for predicting short‐term outcomes in Chinese patients with critically‐ill acute decompensated heart failureRan Mo0Li-tian Yu1Hui-qiong Tan2Yang Wang3Yan-min Yang4Yan Liang5Jun Zhu6Emergency and Intensive Care Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeEmergency and Intensive Care Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeEmergency and Intensive Care Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeEmergency and Intensive Care Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeEmergency and Intensive Care Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeEmergency and Intensive Care Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeEmergency and Intensive Care Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeAbstract Background Acute decompensated heart failure (ADHF) contributes millions of emergency department (ED) visits and it is associated with high in-hospital mortality. The aim of this study was to develop and validate a multiparametric score for critically-ill ADHF patients. Methods In this single-center, retrospective study, a total of 1268 ADHF patients in China were enrolled and divided into derivation (n = 1014) and validation (n = 254) cohorts. The primary endpoint was any in-hospital death, cardiac arrest or utilization of mechanical support devices. Logistic regression model was preformed to identify risk factors and build the new scoring system. The assigning point of each parameter was determined according to its β coefficient. The discrimination was validated internally using C statistic and calibration was evaluated by the Hosmer-Lemeshow goodness-of-fit test. Results We constructed a predictive score based on six significant risk factors [systolic blood pressure (SBP), white blood cell (WBC) count, hematocrit (HCT), total bilirubin (TBIL), estimated glomerular filtration rate (eGFR) and NT-proBNP]. This new model was computed as (1 × SBP < 90 mmHg) + (2 × WBC > 9.2 × 109/L) + (1 × HCT ≤ 0.407) + (2 × TBIL > 34.2 μmol/L) + (2 × eGFR < 15 ml/min/1.73 m2) + (1 × NTproBNP ≥ 10728.9 ng/ml). The C statistic for the new score was 0.758 (95% CI 0.667–0.838) higher than APACHE II, AHEAD and ADHERE score. It also demonstrated good calibration for detecting high-risk patients in the validation cohort (χ2 = 6.681, p = 0.463). Conclusions The new score including SBP, WBC, HCT, TBIL, eGFR and NT-proBNP might be used to predict short-term prognosis of Chinese critically-ill ADHF patients.https://doi.org/10.1186/s12872-021-02041-2Acute decompensated heart failureScoring systemPrognosis |
| spellingShingle | Ran Mo Li-tian Yu Hui-qiong Tan Yang Wang Yan-min Yang Yan Liang Jun Zhu A new scoring system for predicting short‐term outcomes in Chinese patients with critically‐ill acute decompensated heart failure BMC Cardiovascular Disorders Acute decompensated heart failure Scoring system Prognosis |
| title | A new scoring system for predicting short‐term outcomes in Chinese patients with critically‐ill acute decompensated heart failure |
| title_full | A new scoring system for predicting short‐term outcomes in Chinese patients with critically‐ill acute decompensated heart failure |
| title_fullStr | A new scoring system for predicting short‐term outcomes in Chinese patients with critically‐ill acute decompensated heart failure |
| title_full_unstemmed | A new scoring system for predicting short‐term outcomes in Chinese patients with critically‐ill acute decompensated heart failure |
| title_short | A new scoring system for predicting short‐term outcomes in Chinese patients with critically‐ill acute decompensated heart failure |
| title_sort | new scoring system for predicting short term outcomes in chinese patients with critically ill acute decompensated heart failure |
| topic | Acute decompensated heart failure Scoring system Prognosis |
| url | https://doi.org/10.1186/s12872-021-02041-2 |
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