Risk stratification in heart failure decompensation in the community

Because evidence regarding risk stratification predicting prognosis of patients with heart failure (HF) decompensation attended in primary care is lacking, we developed and externally validated a model to forecast death/hospitalization during the first 30 days after an episode of decompensation. The...

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Autores: Verdú Rotellar, Jose María|||0000-0003-4225-8504, Abellana, Rosa|||0000-0003-4487-4431, Vaillant-Roussel, Helene, Gril Jevsek, Lea, Assenova, Radost, Lazic, Djurdjica Kasuba, Torsza, Peter, Glynn, Liam|||0000-0002-6153-9363, Lingner, Heidrun, Demurtas, Jacopo, Thulesius, Hans, Muñoz, Miguel-Angel|||0000-0002-4083-3248
Formato: artículo
Fecha de publicación:2021
País:España
Recursos:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:dnet:uabarcelona_::f8234421ea04653f3fb5dc9a6630bd74
Acesso em linha:https://ddd.uab.cat/record/327530
https://dx.doi.org/urn:doi:10.1002/ehf2.13707
Access Level:acceso abierto
Palavra-chave:Primary care
Heart failure
Decompensation
Risk stratification
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spelling Risk stratification in heart failure decompensation in the communityHEFESTOS scoreVerdú Rotellar, Jose María|||0000-0003-4225-8504Abellana, Rosa|||0000-0003-4487-4431Vaillant-Roussel, HeleneGril Jevsek, LeaAssenova, RadostLazic, Djurdjica KasubaTorsza, PeterGlynn, Liam|||0000-0002-6153-9363Lingner, HeidrunDemurtas, JacopoThulesius, HansMuñoz, Miguel-Angel|||0000-0002-4083-3248Primary careHeart failureDecompensationRisk stratificationBecause evidence regarding risk stratification predicting prognosis of patients with heart failure (HF) decompensation attended in primary care is lacking, we developed and externally validated a model to forecast death/hospitalization during the first 30 days after an episode of decompensation. The predictive model is based on variables easily obtained in primary care settings. HEFESTOS is a multinational study consisting of a derivation cohort of HF patients recruited in 14 primary healthcare centres in Barcelona and a validation cohort from primary healthcare in 9 other European countries. The derivation and validation cohorts included 561 and 250 patients, respectively. Percentages of women in the derivation and validation cohorts were 56.3% and 47.6% (P = 0.026), respectively. Mean age was 82.2 years (SD 8.03) in the derivation cohort, and 79.3 years (SD 10.3) in the validation one (P = 0.001). HF with preserved ejection fraction represented 72.1% in the derivation cohort and 58.8% in the validation one (P = 0.004). Mortality/hospitalization during the first 30 days after a decompensation episode was 30.5% and 26% (P = 0.225) for the derivation and validation cohorts, respectively. Multivariable logistic regression models were performed to develop a score of risk. The identified predictors were worsening of dyspnoea [odds ratio (OR): 2.5; P = 0.001], orthopnoea (OR: 2.16; P = 0.01), paroxysmal nocturnal dyspnoea (OR: 2.25; P = 0.01), crackles (OR: 2.35; P = 0.01), New York Heart Association functional class III/IV (OR: 2.11; P = 0.001), oxygen saturation ≤ 90% (OR: 4.98; P. 22021-01-0120212021-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/327530https://dx.doi.org/urn:doi:10.1002/ehf2.13707reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengThe European General Practice Research Network (EGPRN) HP/2015.036Ministerio de Economía y Competitividad https://doi.org/10.13039/501100003329 PI14/00583open accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:dnet:uabarcelona_::f8234421ea04653f3fb5dc9a6630bd742026-06-06T12:50:31Z
dc.title.none.fl_str_mv Risk stratification in heart failure decompensation in the community
HEFESTOS score
title Risk stratification in heart failure decompensation in the community
spellingShingle Risk stratification in heart failure decompensation in the community
Verdú Rotellar, Jose María|||0000-0003-4225-8504
Primary care
Heart failure
Decompensation
Risk stratification
title_short Risk stratification in heart failure decompensation in the community
title_full Risk stratification in heart failure decompensation in the community
title_fullStr Risk stratification in heart failure decompensation in the community
title_full_unstemmed Risk stratification in heart failure decompensation in the community
title_sort Risk stratification in heart failure decompensation in the community
dc.creator.none.fl_str_mv Verdú Rotellar, Jose María|||0000-0003-4225-8504
Abellana, Rosa|||0000-0003-4487-4431
Vaillant-Roussel, Helene
Gril Jevsek, Lea
Assenova, Radost
Lazic, Djurdjica Kasuba
Torsza, Peter
Glynn, Liam|||0000-0002-6153-9363
Lingner, Heidrun
Demurtas, Jacopo
Thulesius, Hans
Muñoz, Miguel-Angel|||0000-0002-4083-3248
author Verdú Rotellar, Jose María|||0000-0003-4225-8504
author_facet Verdú Rotellar, Jose María|||0000-0003-4225-8504
Abellana, Rosa|||0000-0003-4487-4431
Vaillant-Roussel, Helene
Gril Jevsek, Lea
Assenova, Radost
Lazic, Djurdjica Kasuba
Torsza, Peter
Glynn, Liam|||0000-0002-6153-9363
Lingner, Heidrun
Demurtas, Jacopo
Thulesius, Hans
Muñoz, Miguel-Angel|||0000-0002-4083-3248
author_role author
author2 Abellana, Rosa|||0000-0003-4487-4431
Vaillant-Roussel, Helene
Gril Jevsek, Lea
Assenova, Radost
Lazic, Djurdjica Kasuba
Torsza, Peter
Glynn, Liam|||0000-0002-6153-9363
Lingner, Heidrun
Demurtas, Jacopo
Thulesius, Hans
Muñoz, Miguel-Angel|||0000-0002-4083-3248
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Primary care
Heart failure
Decompensation
Risk stratification
topic Primary care
Heart failure
Decompensation
Risk stratification
description Because evidence regarding risk stratification predicting prognosis of patients with heart failure (HF) decompensation attended in primary care is lacking, we developed and externally validated a model to forecast death/hospitalization during the first 30 days after an episode of decompensation. The predictive model is based on variables easily obtained in primary care settings. HEFESTOS is a multinational study consisting of a derivation cohort of HF patients recruited in 14 primary healthcare centres in Barcelona and a validation cohort from primary healthcare in 9 other European countries. The derivation and validation cohorts included 561 and 250 patients, respectively. Percentages of women in the derivation and validation cohorts were 56.3% and 47.6% (P = 0.026), respectively. Mean age was 82.2 years (SD 8.03) in the derivation cohort, and 79.3 years (SD 10.3) in the validation one (P = 0.001). HF with preserved ejection fraction represented 72.1% in the derivation cohort and 58.8% in the validation one (P = 0.004). Mortality/hospitalization during the first 30 days after a decompensation episode was 30.5% and 26% (P = 0.225) for the derivation and validation cohorts, respectively. Multivariable logistic regression models were performed to develop a score of risk. The identified predictors were worsening of dyspnoea [odds ratio (OR): 2.5; P = 0.001], orthopnoea (OR: 2.16; P = 0.01), paroxysmal nocturnal dyspnoea (OR: 2.25; P = 0.01), crackles (OR: 2.35; P = 0.01), New York Heart Association functional class III/IV (OR: 2.11; P = 0.001), oxygen saturation ≤ 90% (OR: 4.98; P.
publishDate 2021
dc.date.none.fl_str_mv 2
2021-01-01
2021
2021-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/327530
https://dx.doi.org/urn:doi:10.1002/ehf2.13707
url https://ddd.uab.cat/record/327530
https://dx.doi.org/urn:doi:10.1002/ehf2.13707
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.relation.none.fl_str_mv The European General Practice Research Network (EGPRN) HP/2015.036
Ministerio de Economía y Competitividad https://doi.org/10.13039/501100003329 PI14/00583
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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