Performance of Prognostic Risk Scores in Elderly Chinese Patients with Heart Failure

Yalin Cheng, Ke Chai, Wanrong Zhu, Yuhao Wan, Yaodan Liang, Minghui Du, Yingying Li, Ning Sun, Jiefu Yang, Hua Wang Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of ChinaCor...

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Autores principales:	Cheng Y, Chai K, Zhu W, Wan Y, Liang Y, Du M, Li Y, Sun N, Yang J, Wang H
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	heart failure risk score prognosis elderly patient Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/40c673cc7a5447f7b9d74e7ce952649f
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spelling	oai:doaj.org-article:40c673cc7a5447f7b9d74e7ce952649f2021-12-02T15:03:23ZPerformance of Prognostic Risk Scores in Elderly Chinese Patients with Heart Failure1178-1998https://doaj.org/article/40c673cc7a5447f7b9d74e7ce952649f2021-09-01T00:00:00Zhttps://www.dovepress.com/performance-of-prognostic-risk-scores-in-elderly-chinese-patients-with-peer-reviewed-fulltext-article-CIAhttps://doaj.org/toc/1178-1998Yalin Cheng, Ke Chai, Wanrong Zhu, Yuhao Wan, Yaodan Liang, Minghui Du, Yingying Li, Ning Sun, Jiefu Yang, Hua Wang Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of ChinaCorrespondence: Hua WangDepartment of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of ChinaTel/Fax +86-10-85133852Email wanghua2764@bjhmoh.cnPurpose: Elderly heart failure (HF) patients have different clinical characteristics and poorer prognosis compared with younger patients. Prognostic risk scores for HF have not been validated well in elderly patients. We aimed to validate the Seattle Heart Failure Model (SHFM) and the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score in an elderly Chinese HF cohort.Patients and Methods: This retrospective study enrolled 675 elderly HF patients (age≥ 70 years) discharged from our hospital between 2012 and 2017. The performance of the two risk scores was evaluated in terms of discrimination, using receiver-operating characteristic analysis, and calibration using a calibration plot and Hosmer–Lemeshow (H-L) test. Absolute risk reclassification was used to compare the two scores.Results: During the mean follow-up time of 32.6 months, 193 patients (28.6%) died, and 1-year mortality was 10.5%. The predicted median 1-year mortality was 8% for the SHFM and 18% for the MAGGIC score. A Kaplan–Meier survival curve demonstrated that event rates of all-cause mortality significantly increased with increasing SHFM and MAGGIC scores. The discriminatory capacity of the SHFM was greater than that of the MAGGIC score (c-statistics were 0.72 and 0.67, respectively; P = 0.05). The calibration plot for the SHFM was better than that for MAGGIC score for 1-year mortality (SHFM: H-L χ2 =8.2, P = 0.41; MAGGIC: H-L χ2 =18.8, P =0.02). Compared with the MAGGIC score, the net reclassification index (NRI) of the SHFM was 2.96% (Z=5.88, P< 0.0001).Conclusion: The SHFM performs better than MAGGIC score, having good discrimination, calibration and risk classification for the prediction of 1-year mortality in elderly Chinese HF patients.Keywords: heart failure, risk score, prognosis, elderly patientCheng YChai KZhu WWan YLiang YDu MLi YSun NYang JWang HDove Medical Pressarticleheart failurerisk scoreprognosiselderly patientGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 16, Pp 1669-1677 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	heart failure risk score prognosis elderly patient Geriatrics RC952-954.6
spellingShingle	heart failure risk score prognosis elderly patient Geriatrics RC952-954.6 Cheng Y Chai K Zhu W Wan Y Liang Y Du M Li Y Sun N Yang J Wang H Performance of Prognostic Risk Scores in Elderly Chinese Patients with Heart Failure
description	Yalin Cheng, Ke Chai, Wanrong Zhu, Yuhao Wan, Yaodan Liang, Minghui Du, Yingying Li, Ning Sun, Jiefu Yang, Hua Wang Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of ChinaCorrespondence: Hua WangDepartment of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of ChinaTel/Fax +86-10-85133852Email wanghua2764@bjhmoh.cnPurpose: Elderly heart failure (HF) patients have different clinical characteristics and poorer prognosis compared with younger patients. Prognostic risk scores for HF have not been validated well in elderly patients. We aimed to validate the Seattle Heart Failure Model (SHFM) and the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score in an elderly Chinese HF cohort.Patients and Methods: This retrospective study enrolled 675 elderly HF patients (age≥ 70 years) discharged from our hospital between 2012 and 2017. The performance of the two risk scores was evaluated in terms of discrimination, using receiver-operating characteristic analysis, and calibration using a calibration plot and Hosmer–Lemeshow (H-L) test. Absolute risk reclassification was used to compare the two scores.Results: During the mean follow-up time of 32.6 months, 193 patients (28.6%) died, and 1-year mortality was 10.5%. The predicted median 1-year mortality was 8% for the SHFM and 18% for the MAGGIC score. A Kaplan–Meier survival curve demonstrated that event rates of all-cause mortality significantly increased with increasing SHFM and MAGGIC scores. The discriminatory capacity of the SHFM was greater than that of the MAGGIC score (c-statistics were 0.72 and 0.67, respectively; P = 0.05). The calibration plot for the SHFM was better than that for MAGGIC score for 1-year mortality (SHFM: H-L χ2 =8.2, P = 0.41; MAGGIC: H-L χ2 =18.8, P =0.02). Compared with the MAGGIC score, the net reclassification index (NRI) of the SHFM was 2.96% (Z=5.88, P< 0.0001).Conclusion: The SHFM performs better than MAGGIC score, having good discrimination, calibration and risk classification for the prediction of 1-year mortality in elderly Chinese HF patients.Keywords: heart failure, risk score, prognosis, elderly patient
format	article
author	Cheng Y Chai K Zhu W Wan Y Liang Y Du M Li Y Sun N Yang J Wang H
author_facet	Cheng Y Chai K Zhu W Wan Y Liang Y Du M Li Y Sun N Yang J Wang H
author_sort	Cheng Y
title	Performance of Prognostic Risk Scores in Elderly Chinese Patients with Heart Failure
title_short	Performance of Prognostic Risk Scores in Elderly Chinese Patients with Heart Failure
title_full	Performance of Prognostic Risk Scores in Elderly Chinese Patients with Heart Failure
title_fullStr	Performance of Prognostic Risk Scores in Elderly Chinese Patients with Heart Failure
title_full_unstemmed	Performance of Prognostic Risk Scores in Elderly Chinese Patients with Heart Failure
title_sort	performance of prognostic risk scores in elderly chinese patients with heart failure
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/40c673cc7a5447f7b9d74e7ce952649f
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Performance of Prognostic Risk Scores in Elderly Chinese Patients with Heart Failure

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