Predicting hospitalization and mortality in patients with heart failure: The BARDICHE-index

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• 作者：Nicole H.M.K. Uszko-Lencer ; MD^a ; ^b ; ^{n.lencer@mumc.nl} ; Lutz Frankenstein ; MD^c ; Martijn A. Spruit ; PhD^b ; ^d ; Micha T. Maeder ; MD^e ; Marc Gutmann ; MD^f ; Stefano Muzzarelli ; MD^g ; Stefan Osswald ; MD^h ; Matthias E. Pfisterer ; MD^h ; Christian Zugck ; MD^c ; ¹ ; Hans-Peter Brunner-La Rocca ; MD ; PhD^a ; ^h ; ¹ ; the TIME-CHF Investigators²
• 关键词：Chronic heart failure ; Prognostic model ; Survival
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：15 January 2017
• 年：2017
• 卷：227
• 期：Complete
• 页码：901-907
• 全文大小：424 K
• 卷排序：227

文摘

Prediction of events in chronic heart failure (CHF) patients is still difficult and available scores are often complex to calculate. Therefore, we developed and validated a simple-to-use, multidimensional prognostic index for such patients.MethodsA theoretical model was developed based on known prognostic factors of CHF that are easily obtainable: Body mass index (B), Age (A), Resting systolic blood pressure (R), Dyspnea (D), N-termInal pro brain natriuretic peptide (NT-proBNP) (I), Cockroft-Gault equation to estimate glomerular filtration rate (C), resting Heart rate (H), and Exercise performance using the 6-min walk test (E) (the BARDICHE-index). Scores were given for all components and added, the sum ranging from 1 (lowest value) to 25 points (maximal value), with estimated risk being highest in patients with highest scores. Scores were categorized into three groups: a low (≤ 8 points); medium (9–16 points), or high (> 16 points) BARDICHE-score. The model was validated in a data set of 1811 patients from two prospective CHF-cohorts (median follow-up 887 days). The primary outcome was 5-year all-cause survival. Secondary outcomes were 5-year survival without all-cause hospitalization and 5-year survival without CHF-related hospitalization.ResultsThere were significant differences between BARDICHE-risk groups for mortality (hazard ratio = 3.63 per BARDICHE-group, 95%-CI 3.10–4.25), mortality or all-cause hospitalization (HR = 2.00 per BARDICHE-group, 95%-CI 1.83–2.19), and mortality or CHF-related hospitalization (HR = 3.43 per BARDICHE-group, 95%-CI 3.01–3.92; all P < 10–50). Outcome was predicted independently of left ventricular ejection fraction (LVEF) and gender.ConclusionsThe BARDICHE-index is a simple multidimensional prognostic tool for patients with CHF, independently of LVEF.