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The prediction model of the short-term outcome in elderly heart failure patients

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Abstract

This study was designed to investigate the effect of the comprehensive geriatric assessment on the short-term prognosis of the elderly heart failure patients (EHFP), analyze the relevant risk factors, and construct an effective risk prediction model. According to the selection and exclusion criteria, 617 patients were filtered from 800 patients from the cadre ward database of the first Hospital of Jilin University. The EHFP were randomly divided into the model group (432 cases) and the validation group (185 cases). A retrospective study on the general clinical data of patients in the model group was conducted to analyze the risk factors associated with the short-term outcomes of EHFP. Based on the risk factors, the risk prediction model was established and validated through the validation group. In the model group, the following independent risk factors were identified for the short-term outcomes in EHFP in the light of univariate logistic and cox regression analysis: female (β = 0.989, OR = 1.277, 95% CI: 1.090–1.847, P = 0.024), age (65–75 years, β = 0.654, OR = 2.320, 95% CI: 1.135–3.136, P = 0.012; 75–85 years, β = 1.123, OR = 3.159, 95% CI: 1.532–5.189, P = 0.001; age > 85 years old, β = 1.513, OR = 4.895, 95% CI: 1.866–979, P = 0.001), frailty (β = 1.015, OR = 2.761, 95% CI: 1.097–6.945, P = 0.031), malnutrition (β = 1.271, OR = 3.560, 95% CI: 1.122–11.325, P = 0.002), and EF≦40% (β = 1.250, OR = 3.498, 95% CI: 1.898–6.447, P = 0.001). The simple risk prediction score was set up in line with the five risk factors, including range (1–7), the area under ROC curve (0.771, 95% CI: 0.723–0.819), and H–L test (P = 0.393), so patients were divided into the low-risk group (1–3) and the high-risk group (4–8). As a result, the number of EHFP in the high-risk group was significantly much more than that in the low-risk group (70.1% versus 29.9%, P < 0.001). Besides, the area under ROC curve (0.758, 95% CI: 0.682–0.835) and H–L test (P = 0.669) of the validation group indicated that this model could be a promising prediction model for the short-term outcomes of EHFP. Female, age, frailty, malnutrition, and EF ≦ 40% are independent risk factors for short-term outcomes of EHFP. The risk prediction model based on the five risk factors provided compelling clinic predictive value for the short-term prognosis of EHFP.

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The data from this study are not publicly available due to ethical concerns but can be requested from the corresponding author.

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Funding

This research was supported by the Scientific Technological Development Plan Project in Jilin Province of China (20200404207YY) to J.L. and the Development and Reform Commission of Jilin Province of China (2022C043-7) to J.L.

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Authors and Affiliations

  1. Department of Cadre Ward, The First Hospital of Jilin University, No. 71, Xinmin Street, Changchun, Jilin, 130021, China

    Mengyu Cao, Yanmin Ju, Di Yang, Huijing Jin, Kexin Zhang & Jiyan Leng

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  1. Mengyu Cao
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  2. Yanmin Ju
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  3. Di Yang
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  4. Huijing Jin
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  5. Kexin Zhang
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  6. Jiyan Leng
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Contributions

MYC, DY, and JYL drafted the manuscript. MYC and YMJ revised the manuscript. DY, MYC, and HJJ drew the figures. KXZ, DY, and MYC were responsible for the data acquisition. MYC and HJJ performed the data analysis. MYC and YMJ performed the statistical analyses. MYC, YMJ, and JYL conceived of and designed the study. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Jiyan Leng.

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Ethics approval

This study was approved by the institutional review committee of the First Hospital of Jilin University (2IKNo.103–002). This study meets the ethical requirements of Helsinki Declaration.

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Consent was obtained from all participants, and they filled in an informed consent form, including the purpose of the study and the guarantee of anonymity and confidentiality of their information.

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The authors declare no competing interests.

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Cao, M., Ju, Y., Yang, D. et al. The prediction model of the short-term outcome in elderly heart failure patients. Heart Fail Rev 28, 1335–1343 (2023). https://doi.org/10.1007/s10741-023-10323-4

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