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首页> 外文期刊>Journal of cardiology >Risk prediction for 30-day heart failure-specific readmission or death after discharge: Data from the Korean Acute Heart Failure (KorAHF) registry
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Risk prediction for 30-day heart failure-specific readmission or death after discharge: Data from the Korean Acute Heart Failure (KorAHF) registry

机译：排放后30天心力衰竭的入住或死亡风险预测：来自韩国急性心力衰竭（Korahf）登记处的数据

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摘要

BackgroundIdentifying patients with acute heart failure (HF) at high risk for readmission or death after hospital discharge will enable the optimization of treatment and management. The objective of this study was to develop a risk score for 30-day HF-specific readmission or death in Korea.MethodsWe analyzed the data from the Korean Acute Heart Failure (KorAHF) registry to develop a risk score. The model was derived from a multiple logistic regression analysis using a stepwise variable selection method. We also proposed a point-based risk score to predict the risk of 30-day HF-specific readmission or death by simply summing the scores assigned to each risk variable. Model performance was assessed using an area under the receiver operating characteristic curve (AUC), the HosmerLemeshow goodness-of-fit test, the net reclassification improvement (NRI), and the integrated discrimination improvement (IDI) index to evaluate discrimination, calibration, and reclassification, respectively.ResultsData from 4566 patients aged e40 years were included in the analysis. Among them, 446 (9.8%) had 30-day HF-specific readmission or death. The final model included 12 independent variables (age, New York Heart Association functional class, clinical history of hypertension, HF admission, chronic obstructive pulmonary disease, etiology of cardiomyopathy, systolic blood pressure, left ventricular ejection fraction, serum sodium, brain natriuretic peptide, N-terminal prohormone of brain natriuretic peptide at discharge, and prescription of ?blockers and angiotensin-converting enzyme inhibitors or angiotensin II receptor antagonists at discharge). The point risk score showed moderate discrimination (AUC of 0.710; 95% confidence interval, 0.6850.735) and good calibration (?=8.540,p=0.3826).ConclusionsThe risk score for the prediction of the risk of 30-day HF-specific readmission or death after hospital discharge was developed using 12 predictors. It can be utilized to guide appropriate interventions or care strategies for patients with HF.
机译：背景技术在医院放电后，在入院或死亡的高风险下，急性心力衰竭（HF）将能够优化治疗和管理。本研究的目的是在韩国制定30天的HF特定入院或死亡的风险评分。近奇途杂志分析了韩国急性心力衰竭（Korahf）登记处的数据来发展风险分数。使用逐步变量选择方法，该模型从多个逻辑回归分析导出。我们还提出了一种基于点的风险评分，以通过简单地将分配给每个风险变量的分数总结来预测30天的HF特异性入院或死亡的风险。使用接收器操作特性曲线（AUC）下的区域评估模型性能，HosmerlemeShow的健康测试，净重新分类改善（NRI），以及评估歧视，校准和综合歧视改进（IDI）指数来评估歧视，校准和重新分类，分别是4566岁患者的4566名患者的分析。其中，446（9.8％）有30天的HF特定的入院或死亡。最终模型包括12个独立变量（年龄，纽约心脏协会功能阶级，高血压，HF入场，慢性阻塞性肺病，心肌病病因，收缩压，左心室喷射分数，血清钠，脑利钠肽，在排出时脑利钠肽的N-末端前肽，以及α障碍物和血管紧张素转换酶抑制剂或放电时的血管紧张素II受体拮抗剂）。点风险评分显示中等辨别（AUC为0.710; 95％置信区间，0.6850.735）和良好的校准（？= 8.540，P = 0.3826）。预测30天HF特定风险的风险评分使用12个预测因子开发出院后的阅迟或死亡。它可用于指导HF患者的适当干预或护理策略。

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  • 来源
    《Journal of cardiology》 |2019年第2期|共6页
  • 作者

    Nam-Kyoo Lim; Sang Eun Lee; Hae-Young Lee; Hyun-Jai Cho; Won-Seok Choe; Hokon Kim; Jin Oh Choi; Eun-Seok Jeon; Min-Seok Kim; Jae-Joong Kim; Kyung-Kuk Hwang; Shung Chull Chae; Sang Hong Baek; Seok-Min Kang; Dong-Ju Choi; Byung-Su Yoo; Kye Hun Kim; Myeong-Chan Cho; Byung-Hee Oh; Hyun-Young Park;

  • 作者单位

    Division of Cardiovascular Diseases Korea National Institute of Health;

    Department of Internal Medicine Asan Medical Center University of Ulsan College of Medicine;

    Department of Internal Medicine Seoul National University Hospital;

    Department of Internal Medicine Seoul National University Hospital;

    Department of Internal Medicine Seoul National University Hospital;

    Department of Internal Medicine Seoul National University Hospital;

    Department of Internal Medicine Sungkyunkwan University College of Medicine;

    Department of Internal Medicine Sungkyunkwan University College of Medicine;

    Department of Internal Medicine Asan Medical Center University of Ulsan College of Medicine;

    Department of Internal Medicine Asan Medical Center University of Ulsan College of Medicine;

    Department of Internal Medicine Chungbuk National University College of Medicine;

    Department of Internal Medicine Kyungpook National University College of Medicine;

    Department of Internal Medicine College of Medicine The Catholic University of Korea;

    Department of Internal Medicine Yonsei University College of Medicine;

    Department of Internal Medicine Seoul National University Bundang Hospital;

    Department of Internal Medicine Yonsei University Wonju College of Medicine;

    Department of Internal Medicine Heart Research Center of Chonnam National University;

    Department of Internal Medicine Chungbuk National University College of Medicine;

    Department of Internal Medicine Seoul National University Hospital;

    Division of Cardiovascular Diseases Korea National Institute of Health;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 心脏、血管（循环系）疾病;
  • 关键词

    Heart failure; 30-day readmission; Risk score;

    机译：心力衰竭;30天的入院;风险分数;

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