Prognostic Value of Self-Reported Subjective Exercise Capacity in Patients With Acute Dyspnea.
JACC Adv
; 2(3): 100342, 2023 May.
Article
em En
| MEDLINE
| ID: mdl-38939580
ABSTRACT
Background:
Self-reported exercise capacity is a well-established prognostic measure in stable ambulatory patients with cardiac and pulmonary disease.Objectives:
The authors aimed to directly compare the prognostic accuracy of quantified self-reported exercise capacity using the Duke Activity Status Index (DASI) with the established objective disease-severity marker B-type natriuretic peptide (BNP) in patients presenting with acute dyspnea to the emergency department.Methods:
The DASI was obtained in a prospective multicenter diagnostic study recruiting unselected patients presenting with acute dyspnea to the emergency department. The prognostic accuracy of DASI and BNP for 90-day and 720-day all-cause mortality was evaluated using C-index.Results:
Among 1,019 patients eligible for this analysis, 75 (7%) and 297 (29%) patients died within 90 and 720 days after presentation, respectively. Unadjusted hazard ratios (HRs) and multivariable adjusted hazard ratios (aHRs) for 90- and 720-day mortality increased continuously from the fourth (best self-reported exercise capacity) to the first DASI quartile (worst self-reported exercise capacity). For 720-day mortality the HR of the first quartile vs the fourth was 9.1 (95% CI, 5.5-14.9) vs (aHR 6.1, 95% CI 3.7-10.1), of the second quartile 6.4 (95% CI 3.9-10.6) vs (aHR 4.4, 95% CI 2.6-7.3), while of the third quartile the HR was 3.2 (95% CI 1.9-5.5) vs (aHR 2.4, 95% CI 1.4-4.0). The prognostic accuracy of the DASI score was high, and higher than that of BNP concentrations (720-day mortality C-index 0.67 vs 0.62; P = 0.024).Conclusions:
Quantification of self-reported subjective exercise capacity using the DASI provides high prognostic accuracy and may aid physicians in risk stratification. (Basics in Acute Shortness of Breath EvaLuation [BASEL V] Study [BASEL V]; NCT01831115).
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Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Revista:
JACC Adv
Ano de publicação:
2023
Tipo de documento:
Article