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DC Field | Value | Language |
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dc.contributor.author | Verdú Rotellar, Jose Maria | - |
dc.contributor.author | Abellana Sangrà, Rosa Mari | - |
dc.contributor.author | Vaillant-Roussel, Helene | - |
dc.contributor.author | Gril Jevsek, Lea | - |
dc.contributor.author | Assenova, Radost | - |
dc.contributor.author | Kasuba Lazic, Djurdjica | - |
dc.contributor.author | Torsza, Peter | - |
dc.contributor.author | Glynn, Liam George | - |
dc.contributor.author | Lingner, Heidrun | - |
dc.contributor.author | Demurtas, Jacopo | - |
dc.contributor.author | Thulesius, Hans | - |
dc.contributor.author | Muñoz, Miguel Ángel | - |
dc.contributor.author | HEFESTOS group | - |
dc.date.accessioned | 2022-02-17T19:53:18Z | - |
dc.date.available | 2022-02-17T19:53:18Z | - |
dc.date.issued | 2021-11-22 | - |
dc.identifier.issn | 2055-5822 | - |
dc.identifier.uri | http://hdl.handle.net/2445/183271 | - |
dc.description.abstract | Aims: 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. Methods and results: 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 < 0.001), heart rate > 100 b.p.m. (OR: 2.72; P = 0.002), and previous hospitalization due to HF (OR: 2.45; P < 0.001). The model showed an area under the curve (AUC) of 0.807, 95% confidence interval (CI): [0.770; 0.845] in the derivation cohort and AUC 0.73, 95% CI: [0.660; 0.808] in the validation one. No significant differences between both cohorts were observed (P = 0.08). Regarding probability of hospitalization/death, three risk groups were defined: low <5%, medium 5-20%, and high >20%. Outcome incidence was 2.7% for the low-risk group, 12.8% for medium risk, and 46.2% for high risk in the derivation cohort, and 9.1%, 12.9%, and 39.6% in the validation one. Conclusions: The HEFESTOS score, based on variables easily accessible in a community setting and validated in an external European cohort, properly predicted the risk of death/hospitalization during the first 30 days after an HF decompensation episode. | - |
dc.format.extent | 11 p. | - |
dc.format.mimetype | application/pdf | - |
dc.language.iso | eng | - |
dc.publisher | John Wiley & Sons | - |
dc.relation.isformatof | Reproducció del document publicat a: https://doi.org/10.1002/ehf2.13707 | - |
dc.relation.ispartof | ESC Heart Failure, 2021, vol. 9, num. 1, p. 606-613 | - |
dc.relation.uri | https://doi.org/10.1002/ehf2.13707 | - |
dc.rights | cc-by-nc-nd (c) Verdú Rotellar, Jose Maria. et al., 2021 | - |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/4.0/ | - |
dc.source | Articles publicats en revistes (Fonaments Clínics) | - |
dc.subject.classification | Insuficiència cardíaca | - |
dc.subject.classification | Avaluació del risc per la salut | - |
dc.subject.other | Heart failure | - |
dc.subject.other | Health risk assessment | - |
dc.title | Risk stratification in heart failure decompensation in the community: HEFESTOS score | - |
dc.type | info:eu-repo/semantics/article | - |
dc.type | info:eu-repo/semantics/publishedVersion | - |
dc.identifier.idgrec | 718186 | - |
dc.date.updated | 2022-02-17T19:53:19Z | - |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | - |
Appears in Collections: | Articles publicats en revistes (Fonaments Clínics) |
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