Risk prediction for 30-day heart failure-specific readmission or death after discharge: Data from the Korean Acute Heart Failure (KorAHF) registry

Abstract

Background: Identifying 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. Methods: We 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 Hosmer-Lemeshow goodness-of-fit test, the net reclassification improvement (NRI), and the integrated discrimination improvement (IDI) index to evaluate discrimination, calibration, and reclassification, respectively. Results: Data from 4566 patients aged !40 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 b-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, 0.685-0.735) and good calibration (x 2 = 8.540, p = 0.3826).

Predictive Factors on the Incidence of Heart Failure in Patients with Ischemic Heart Disease: Using a 10-Year Population-Based Korea National Health Insurance Cohort Data

“…In this current study, patients with a history of hypertension had 17.2% lower incidence of HF than those with no hypertension. This finding is similar to a prospective study of acute HF patients in Korea where univariate analysis showed that patients who were prescribed beta-blockers, angiotensin converting enzyme inhibitors (ACEI), or angiotensin II receptor blockers (ARB) at discharge had relatively low hospitalization and mortality rates within 30 days [24]. This is because the antihypertensive agents have a similar pharmacological action to the beta blockers and ACEI or ARB.…”

Association of the induction of a self-care management system with 1-year outcomes in patients hospitalized for heart failure

“…It was possible that the patient visited the nearest physician outpatient clinic when the patient had !3 H F points. Lim et al reported the risk score for the prediction of the 30-day HF readmission or death after hospital discharge [16]. Combined use of the risk score with our self-care point system may be more effective in preventing HF readmissions.…”

Six-minute walking test distance predicts readmission in hospitalized heart failure patient in integrated cardiac centre, Makassar, Indonesia

“…Among them, 446 (9.8%) had a 30-day readmission showing sensitivity (AUC of 0.710; 95% confidence interval, 0.685-0.735). 14 The results of the research conducted also found the same thing, there was a strong correlation between 6-MWT and a 30-day readmission. Sixty-one patients (52% female, mean age 46.9±14.1 years, 6-MWT distance 336.3±65 meters) had 27.6±12.8 days readmission, twenty one patients (45 , 3%) readmissions, with patients who readmissions having a shorter 6-MWD (p=0.007) and more likely to die than those who were not readmitted (RR=1.72, 95% CI= 1.13-2.62, p=0.003).…”