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

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

Research output: Contribution to journalArticle

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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 β-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 (χ2 = 8.540, p = 0.3826). Conclusions: The 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.

Original languageEnglish
Pages (from-to)108-113
Number of pages6
JournalJournal of Cardiology
Volume73
Issue number2
DOIs
Publication statusPublished - 2019 Feb

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Registries
Heart Failure
Brain Natriuretic Peptide
Calibration
Area Under Curve
Blood Pressure
Angiotensin Receptor Antagonists
Korea
Cardiomyopathies
Angiotensin-Converting Enzyme Inhibitors
ROC Curve
Stroke Volume
Chronic Obstructive Pulmonary Disease
Prescriptions
Patient Care
Logistic Models
Sodium
Regression Analysis
Confidence Intervals
Hypertension

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Lim, Nam Kyoo ; Lee, Sang Eun ; Lee, Hae Young ; Cho, Hyun Jai ; Choe, Won Seok ; Kim, Hokon ; Choi, Jin Oh ; Jeon, Eun Seok ; Kim, Min Seok ; Kim, Jae Joong ; Hwang, Kyung Kuk ; Chae, Shung Chull ; Baek, Sang Hong ; Kang, Seok Min ; Choi, Dong Ju ; Yoo, Byung Su ; Kim, Kye Hun ; Cho, Myeong Chan ; Oh, Byung Hee ; Park, Hyun Young. / Risk prediction for 30-day heart failure-specific readmission or death after discharge : Data from the Korean Acute Heart Failure (KorAHF) registry. In: Journal of Cardiology. 2019 ; Vol. 73, No. 2. pp. 108-113.
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title = "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 β-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 (χ2 = 8.540, p = 0.3826). Conclusions: The 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.",
author = "Lim, {Nam Kyoo} and Lee, {Sang Eun} and Lee, {Hae Young} and Cho, {Hyun Jai} and Choe, {Won Seok} and Hokon Kim and Choi, {Jin Oh} and Jeon, {Eun Seok} and Kim, {Min Seok} and Kim, {Jae Joong} and Hwang, {Kyung Kuk} and Chae, {Shung Chull} and Baek, {Sang Hong} and Kang, {Seok Min} and Choi, {Dong Ju} and Yoo, {Byung Su} and Kim, {Kye Hun} and Cho, {Myeong Chan} and Oh, {Byung Hee} and Park, {Hyun Young}",
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Lim, NK, Lee, SE, Lee, HY, Cho, HJ, Choe, WS, Kim, H, Choi, JO, Jeon, ES, Kim, MS, Kim, JJ, Hwang, KK, Chae, SC, Baek, SH, Kang, SM, Choi, DJ, Yoo, BS, Kim, KH, Cho, MC, Oh, BH & Park, HY 2019, 'Risk prediction for 30-day heart failure-specific readmission or death after discharge: Data from the Korean Acute Heart Failure (KorAHF) registry', Journal of Cardiology, vol. 73, no. 2, pp. 108-113. https://doi.org/10.1016/j.jjcc.2018.07.009

Risk prediction for 30-day heart failure-specific readmission or death after discharge : Data from the Korean Acute Heart Failure (KorAHF) registry. / Lim, Nam Kyoo; Lee, Sang Eun; Lee, Hae Young; Cho, Hyun Jai; Choe, Won Seok; Kim, Hokon; Choi, Jin Oh; Jeon, Eun Seok; Kim, Min Seok; Kim, Jae Joong; Hwang, Kyung Kuk; Chae, Shung Chull; Baek, Sang Hong; Kang, Seok Min; Choi, Dong Ju; Yoo, Byung Su; Kim, Kye Hun; Cho, Myeong Chan; Oh, Byung Hee; Park, Hyun Young.

In: Journal of Cardiology, Vol. 73, No. 2, 02.2019, p. 108-113.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Risk prediction for 30-day heart failure-specific readmission or death after discharge

T2 - Data from the Korean Acute Heart Failure (KorAHF) registry

AU - Lim, Nam Kyoo

AU - Lee, Sang Eun

AU - Lee, Hae Young

AU - Cho, Hyun Jai

AU - Choe, Won Seok

AU - Kim, Hokon

AU - Choi, Jin Oh

AU - Jeon, Eun Seok

AU - Kim, Min Seok

AU - Kim, Jae Joong

AU - Hwang, Kyung Kuk

AU - Chae, Shung Chull

AU - Baek, Sang Hong

AU - Kang, Seok Min

AU - Choi, Dong Ju

AU - Yoo, Byung Su

AU - Kim, Kye Hun

AU - Cho, Myeong Chan

AU - Oh, Byung Hee

AU - Park, Hyun Young

PY - 2019/2

Y1 - 2019/2

N2 - 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 β-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 (χ2 = 8.540, p = 0.3826). Conclusions: The 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.

AB - 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 β-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 (χ2 = 8.540, p = 0.3826). Conclusions: The 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.

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