Added value of frailty and social support in predicting risk of 30-day unplanned re-admission or death for patients with heart failure: An analysis from OPERA-HF

I Sokoreli, J G Cleland, S C Pauws, E W Steyerberg, J J G de Vries, J M Riistama, K Dobbs, J Bulemfu, A L Clark

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Abstract

Background: Models for predicting the outcome of patients hospitalized for heart failure (HF) rarely take a holistic view. We assessed the ability ofmeasures of frailty and social support in addition to demographic, clinical, imaging and laboratory variables to predict short-term outcome for patients discharged after a hospitalization for HF.

Methods: OPERA-HF is a prospective observational cohort, enrolling patients hospitalized for HF in a single center in Hull, UK. Variables were combined in a logistic regression model after multiple imputation of missing data to predict the composite outcome of death or readmission at 30 days. Comparisons were made to a model using clinical variables alone. The discriminative performance of each model was internally validated with bootstrap re-sampling.

Results: 1094 patients were included (mean age 77 [interquartile range 68-83] years; 40% women; 56% with moderate to severe left ventricular systolic dysfunction) of whom 213 (19%) had an unplanned re-admission and 60 (5%) died within 30 days. For the composite outcome, a model containing clinical variables alone had an area under the receiver-operating characteristic curve (AUC) of 0.68 [95% CI 0.64-0.72]. Adding marital status, support from family and measures of physical frailty increased the AUC (p <0.05) to 0.70 [95% CI 0.66-0.74].

Conclusions: Measures of physical frailty and social support improve prediction of 30-day outcome after an admission for HF but predicting near-term events remains imperfect. Further external validation and improvement of the model is required. (c) 2018 Elsevier B. V. All rights reserved.

Original languageEnglish
Pages (from-to)167-172
Number of pages6
JournalInternational Journal of Cardiology
Volume278
DOIs
Publication statusPublished - 1 Mar 2019

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Keywords

  • 30-day re-admission
  • ANXIETY
  • DEPRESSION
  • DIAGNOSIS
  • DISEASE
  • Frailty
  • GO
  • Heart failure
  • MODELS
  • MORTALITY
  • Mortality
  • Psychosocial factors
  • READMISSION

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