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Cardiol J ; 19(6): 578-85, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-23224919

RESUMEN

BACKGROUND: Congestive heart failure (HF) is a chronic, frequent and disabling condition but with a modifiable course and a large potential for improving. The aim of this project was to develop a clinical prediction model of biological and non biological factors in patients with first diagnosis of HF that facilitates the risk-stratification and decision-making process at the point of care. METHODS AND RESULTS: Historical cohort analysis of 600 patients attended at three tertiary hospitals and diagnosed of a first episode of HF according Framingham criteria. There were followed 1 year. We analyzed sociodemographic, clinical and laboratory data with potential prognostic value. The modelling process concluded into a logistic regression multivariable analysis and a predictive rule: PREDICE SCORE. Age, dependency for daily basic activities, creatinine clearance, sodium levels at admission and systolic dysfunction diagnosis (HF with left ventricular ejection fraction 〈 40%) were the selected variables. The model showed a c-statistic of 0.763. PREDICE Score, has range of 22 points to stratifications of 1-year mortality. CONCLUSIONS: The follow-up of 600 patients hospitalized by a first episode of congestive HF, allowed us to obtain a predictive 1 year mortality model from the combination of demographic data, routine biochemistry and easy handling social and functional variables at the point of care. The variables included were non-invasive, undemanding to collect, and widely available. It allows for risk stratification and therapeutical targeting and may help in the clinical decisions process in a sustainable way.


Asunto(s)
Insuficiencia Cardíaca/mortalidad , Insuficiencia Cardíaca/fisiopatología , Sístole , Disfunción Ventricular Izquierda/mortalidad , Disfunción Ventricular Izquierda/fisiopatología , Distribución por Edad , Anciano , Anciano de 80 o más Años , Algoritmos , Biomarcadores/sangre , Estudios de Cohortes , Creatinina/sangre , Femenino , Estudios de Seguimiento , Insuficiencia Cardíaca/sangre , Insuficiencia Cardíaca/diagnóstico , Hospitales Universitarios , Humanos , Estilo de Vida , Modelos Logísticos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Medición de Riesgo , Factores de Riesgo , Sensibilidad y Especificidad , Sodio/sangre , España/epidemiología , Tasa de Supervivencia , Disfunción Ventricular Izquierda/sangre , Disfunción Ventricular Izquierda/diagnóstico
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