dc.contributor.author
Blum, Moritz
dc.contributor.author
Gelfman, Laura P.
dc.contributor.author
McKendrick, Karen
dc.contributor.author
Pinney, Sean P.
dc.contributor.author
Goldstein, Nathan E.
dc.date.accessioned
2023-03-31T11:28:28Z
dc.date.available
2023-03-31T11:28:28Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/38774
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-38490
dc.description.abstract
Background: Score-based survival prediction in patients with advanced heart failure (HF) is complicated. Easy-to-use prognostication tools could inform clinical decision-making and palliative care delivery.
Objective: To compare the prognostic utility of the Seattle HF model (SHFM), the surprise question (SQ), and the number of HF hospitalizations (NoH) within the last 12 months for predicting 1-year survival in patients with advanced HF.
Methods: We retrospectively analyzed data from a cluster-randomized controlled trial of advanced HF patients, predominantly with reduced ejection fraction. Primary outcome was the prognostic discrimination of SHFM, SQ (“Would you be surprised if this patient were to die within 1 year?”) answered by HF cardiologists, and NoH, assessed by receiver operating characteristic (ROC) curve analysis. Optimal cut-offs were calculated using Youden’s index (SHFM: <86% predicted 1-year survival; NoH ≥ 2).
Results: Of 535 subjects, 82 (15.3%) had died after 1-year of follow-up. SHFM, SQ, and NoH yielded a similar area under the ROC curve [SHFM: 0.65 (0.60–0.71 95% CI); SQ: 0.58 (0.54–0.63 95% CI); NoH: 0.56 (0.50–0.62 95% CI)] and similar sensitivity [SHFM: 0.76 (0.65–0.84 95% CI); SQ: 0.84 (0.74–0.91 95% CI); NoH: 0.56 (0.45–0.67 95% CI)]. As compared to SHFM, SQ had lower specificity [SQ: 0.33 (0.28–0.37 95% CI) vs. SHFM: 0.55 (0.50–0.60 95% CI)] while NoH had similar specificity [0.56 (0.51–0.61 95% CI)]. SQ combined with NoH showed significantly higher specificity [0.68 (0.64–0.73 95% CI)].
Conclusion: SQ and NoH yielded comparable utility to SHFM for 1-year survival prediction among advanced HF patients, are easy-to-use and could inform bedside decision-making.
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
survival prediction
en
dc.subject
number of hospitalizations
en
dc.subject
Seattle Heart Failure Model
en
dc.subject
advanced heart failure
en
dc.subject
surprise question
en
dc.subject
palliative care
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Enhancing Palliative Care for Patients With Advanced Heart Failure Through Simple Prognostication Tools: A Comparison of the Surprise Question, the Number of Previous Heart Failure Hospitalizations, and the Seattle Heart Failure Model for Predicting 1-Year Survival
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.articlenumber
836237
dcterms.bibliographicCitation.doi
10.3389/fcvm.2022.836237
dcterms.bibliographicCitation.journaltitle
Frontiers in Cardiovascular Medicine
dcterms.bibliographicCitation.originalpublishername
Frontiers Media SA
dcterms.bibliographicCitation.volume
9
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
35479267
dcterms.isPartOf.eissn
2297-055X