Use of the ADHERE Risk Model as a Predictor of Risk of in-Hospital Worsening Heart Failure in a Cohort.

IF 2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Arquivos Brasileiros de Cardiologia Pub Date : 2023-09-01 eCollection Date: 2023-01-01 DOI:10.36660/abc.20220584

Daniela de Souza Bernardes, Marina Scherer Santos, Vanessa Monteiro Mantovani, Omar Pereira de Almeida Neto, Livia Adams Goldraich, Nadine Clausell, Eneida Rejane Rabelo-Silva

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引用次数: 1

Abstract

Background: Patients admitted with acute decompensated heart failure (HF) are subject to developing worsening episodes that require more complex interventions. The Acute Decompensated Heart Failure National Registry (ADHERE) risk model was developed in the United States to predict the risk of in-hospital worsening HF.

Objective: To use the ADHERE risk model in the assessment of risk of in-hospital worsening HF and to determine its sensitivity and specificity in hospitalized patients.

Methods: This cohort study was conducted at a Brazilian public university hospital, and data from 2013 to 2020 were retrospectively collected. P values < 0.05 were considered statistically significant.

Results: A total of 890 patients with a mean age of 74 ± 8 years were included. The model showed that, in the group of 490 patients at risk, 254 (51.8%) developed in-hospital worsening HF. In the group of 400 patients not at risk, only 109 (27.2%) experienced worsening HF. The results demonstrated a statistically significant curve (area under the curve = 0.665; standard error = 0.018; P < 0.01; confidence interval = 0.609 to 0.701), indicating good accuracy. The model had a sensitivity of 69.9% and a specificity of 55.2%, with a positive predictive value of 52% and a negative predictive value of 72.7%.

Conclusions: In this cohort, we showed that the ADHERE risk model was able to discriminate patients who in fact developed worsening HF during the admission period, from those who did not.

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使用ADHERE风险模型作为队列中住院恶化心力衰竭风险的预测指标。

背景：急性失代偿性心力衰竭（HF）患者病情恶化，需要更复杂的干预措施。美国开发了急性失代偿性心力衰竭国家注册中心（ADHERE）风险模型来预测住院期间心衰恶化的风险。目的：使用ADHERE风险模型评估住院期间心衰加重的风险，并确定其在住院患者中的敏感性和特异性。方法：该队列研究在巴西一所公立大学医院进行，回顾性收集2013年至2020年的数据。P值<0.05被认为具有统计学意义。结果：共纳入890名患者，平均年龄74±8岁。该模型显示，在490名有风险的患者中，254名（51.8%）患者在医院内出现心衰恶化。在400名无风险的患者组中，只有109名（27.2%）患者出现HF恶化。结果显示了一条具有统计学意义的曲线（曲线下面积=0.665；标准误差=0.018；P<0.01；置信区间=0.609至0.701），表明准确性良好。该模型的敏感性为69.9%，特异性为55.2%，阳性预测值为52%，阴性预测值为72.7%。

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来源期刊

Arquivos Brasileiros de Cardiologia 医学-心血管系统

CiteScore

3.70

自引率

30.80%

发文量

234

审稿时长

3-8 weeks

期刊介绍： With more than 70 years of existence, Arquivos Brasileiros de Cardiologia is the main channel for the dissemination of Brazilian scientific research on cardiovascular sciences. Published in two languages and indexed in major international databases, all scientific contributions are peer-reviewed and reviewed by editorial board members selected among the most reputable researchers in Brazil and abroad. The manuscripts are reviewed according to their relevance and originality, scientific accuracy and level of importance for the advancement of science. With an average time of nine months between the initial submission and the effective publication of the manuscripts, and less than seven months until they are published on PubMed, Arquivos Brasileiros de Cardiologia can ensure the quick inclusion of the researchers’ papers in the international literature.