Comparison of Mortality Prediction Models on Long-Term Mortality in Hospitalized Patients With Acute Heart Failure　― The Importance of Accounting for Nutritional Status ―

• Nakano Hiroki

  Department of Cardiovascular Medicine, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center Department of Cardiology, Tokyo Medical University

• Omote Kazunori

  Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University

• Nagai Toshiyuki

  Department of Cardiovascular Medicine, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University National Heart and Lung Institute, Imperial College London

• Nakai Michikazu

  Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center

• Nishimura Kunihiro

  Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center

• Honda Yasuyuki

  Department of Cardiovascular Medicine, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center

• Honda Satoshi

  Department of Cardiovascular Medicine, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center

• Iwakami Naotsugu

  Department of Cardiovascular Medicine, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center

• Sugano Yasuo

  Department of Cardiovascular Medicine, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center

• Asaumi Yasuhide

  Department of Cardiovascular Medicine, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center

• Aiba Takeshi

  Department of Cardiovascular Medicine, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center

• Noguchi Teruo

  Department of Cardiovascular Medicine, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center

• Kusano Kengo

  Department of Cardiovascular Medicine, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center

• Yokoyama Hiroyuki

  Department of Cardiovascular Medicine, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center

• Yasuda Satoshi

  Department of Cardiovascular Medicine, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center

• Ogawa Hisao

  Department of Cardiovascular Medicine, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center

• Chikamori Taishiro

  Department of Cardiology, Tokyo Medical University

• Anzai Toshihisa

  Department of Cardiovascular Medicine, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University

• on behalf of the NaDEF Investigators

Abstract

Background: The ideal mortality prediction model (MPM) for acute heart failure (AHF) patients would have sufficient and stable predictive ability for long-term as well as short-term mortality. However, published MPMs for AHF predominantly predict short-term mortality up to 90 days, and their prognostic performance for long-term mortality remains unclear. Methods and Results: We analyzed 609 AHF patients in a prospective registry from January 2013 to May 2016. We compared the prognostic performance for long-term mortality among 8 systematically identified MPMs for AHF that predict short-term mortality up to 90 days from admission. The PROTECT 7-day model showed the highest c-index for long-term as well as short-term mortality among the studied MPMs. Sensitivity analyses revealed serum albumin and total cholesterol to be the most important variables, as dropping these variables resulted in a significant decline in c-index, when compared with other variables specific to the PROTECT 7-day model. Furthermore, significant improvements in c-index and net reclassification were observed when serum albumin or serum albumin plus total cholesterol was added to the studied MPMs, other than the PROTECT 7-day model. Conclusions: The PROTECT 7-day model demonstrated the highest predictive performance for long-term as well as short-term mortality in AHF patients among the published MPMs. Our findings indicate the importance of accounting for nutritional status such as serum albumin and total cholesterol in AHF patients when developing a MPM.

Journal

• Circulation Journal

  Circulation Journal 83 (3), 614-621, 2019-02-25

  The Japanese Circulation Society

Keywords

• Acute heart failure
• Mortality prediction
• Nutrition

Details

• CRID: 1390845713053842560
• NII Article ID: 130007604358
• NII Book ID: AA11591968
• DOI: 10.1253/circj.cj-18-1243
• ISSN: 13474820
• ISSN: 13469843
• NDL BIB ID: 029537827
• PubMed: 30700666
• Web Site: http://id.ndl.go.jp/bib/029537827
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I029537827
• Web Site: https://www.jstage.jst.go.jp/article/circj/83/3/83_CJ-18-1243/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2019303203
• Text Lang: en
• Data Source:
  • JaLC
  • NDL
  • Crossref
  • PubMed
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed