Fluid status assessment in heart failure patients: pilot validation of the Maastricht Decompensation Questionnaire.

Abstract

Background: eHealth products have the potential to enhance heart failure (HF) care by identifying at-risk patients. However, existing risk models perform modestly and require extensive data, limiting their practical application in clinical settings. This study aims to address this gap by validating a more suitable risk model for eHealth integration.

Methods: We developed the Maastricht Decompensation Questionnaire (MDQ) based on expert opinion to assess HF patients' fluid status using common signs and symptoms. Subsequently, the MDQ was administered to a cohort of HF outpatients at Maastricht University Medical Centre. Patients with ≥ 10 MDQ points were categorised as 'decompensated', patients with < 10 MDQ points as 'not decompensated'. HF nurses, blinded to MDQ scores, served as the gold standard for fluid status assessment. Patients were classified as 'correctly' if MDQ and nurse assessments aligned; otherwise, they were classified as 'incorrectly'.

Results: A total of 103 elderly HF patients were included. The MDQ classified 50 patients as 'decompensated', with 17 of them being correctly classified (34%). Additionally, 53 patients were categorised as 'not decompensated', with 48 of them being correctly classified (90%). The calculated area under the curve was 0.69 (95% confidence interval: 0.57-0.81; p < 0.05). Cronbach's alpha reliability coefficient for the MDQ was 0.85.

Conclusions: The MDQ helps identify decompensated HF patients through clinical signs and symptoms. Further trials with larger samples are needed to confirm its validity, reliability and applicability. Tailoring the MDQ to individual patient profiles may improve its accuracy.