Risk prediction in patients with heart failure: A systematic review and analysis

Kazem Rahimi, Derrick Bennett, Nathalie Conrad, Timothy M. Williams, Joyee Basu, Jeremy Dwight, Mark Woodward, Anushka Patel, John McMurray, Stephen MacMahon

Research output: Contribution to journalArticle

Abstract

Objectives: This study sought to review the literature for risk prediction models in patients with heart failure and to identify the most consistently reported independent predictors of risk across models. Background: Risk assessment provides information about patient prognosis, guides decision making about the type and intensity of care, and enables better understanding of provider performance. Methods: MEDLINE and EMBASE were searched from January 1995 to March 2013, followed by hand searches of the retrieved reference lists. Studies were eligible if they reported at least 1 multivariable model for risk prediction of death, hospitalization, or both in patients with heart failure and reported model performance. We ranked reported individual risk predictors by their strength of association with the outcome and assessed the association of model performance with study characteristics. Results: Sixty-four main models and 50 modifications from 48 studies met the inclusion criteria. Of the 64 main models, 43 models predicted death, 10 hospitalization, and 11 death or hospitalization. The discriminatory ability of themodels for prediction of death appeared to be higher than that for prediction of death or hospitalization or prediction of hospitalization alone (p= 0.0003). A wide variation between studies in clinical settings, population characteristics, sample size, and variables used for model development was observed, but these features were not significantly associated with the discriminatory performance of the models. A few strong predictors emerged for prediction of death; the most consistently reported predictors were age, renal function, blood pressure, blood sodium level, left ventricular ejection fraction, sex, brain natriuretic peptide level, New York Heart Association functional class, diabetes, weight or body mass index, and exercise capacity. Conclusions: There are several clinically useful and well-validated death prediction models in patients with heartfailure. Although the studies differed in many respects, the models largely included a few common markers ofrisk.

Original languageEnglish (US)
Pages (from-to)440-446
Number of pages7
JournalJACC: Heart Failure
Volume2
Issue number5
DOIs
StatePublished - Oct 1 2014
Externally publishedYes

Fingerprint

Heart Failure
Hospitalization
Aptitude
Brain Natriuretic Peptide
Population Characteristics
MEDLINE
Stroke Volume
Sample Size
Decision Making
Body Mass Index
Sodium
Exercise
Blood Pressure
Kidney
Weights and Measures

Keywords

  • Death
  • Heart failure
  • Hospitalization
  • Multivariable model
  • Risk prediction
  • Systematic review

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Rahimi, K., Bennett, D., Conrad, N., Williams, T. M., Basu, J., Dwight, J., ... MacMahon, S. (2014). Risk prediction in patients with heart failure: A systematic review and analysis. JACC: Heart Failure, 2(5), 440-446. https://doi.org/10.1016/j.jchf.2014.04.008

Risk prediction in patients with heart failure : A systematic review and analysis. / Rahimi, Kazem; Bennett, Derrick; Conrad, Nathalie; Williams, Timothy M.; Basu, Joyee; Dwight, Jeremy; Woodward, Mark; Patel, Anushka; McMurray, John; MacMahon, Stephen.

In: JACC: Heart Failure, Vol. 2, No. 5, 01.10.2014, p. 440-446.

Research output: Contribution to journalArticle

Rahimi, K, Bennett, D, Conrad, N, Williams, TM, Basu, J, Dwight, J, Woodward, M, Patel, A, McMurray, J & MacMahon, S 2014, 'Risk prediction in patients with heart failure: A systematic review and analysis', JACC: Heart Failure, vol. 2, no. 5, pp. 440-446. https://doi.org/10.1016/j.jchf.2014.04.008
Rahimi K, Bennett D, Conrad N, Williams TM, Basu J, Dwight J et al. Risk prediction in patients with heart failure: A systematic review and analysis. JACC: Heart Failure. 2014 Oct 1;2(5):440-446. https://doi.org/10.1016/j.jchf.2014.04.008
Rahimi, Kazem ; Bennett, Derrick ; Conrad, Nathalie ; Williams, Timothy M. ; Basu, Joyee ; Dwight, Jeremy ; Woodward, Mark ; Patel, Anushka ; McMurray, John ; MacMahon, Stephen. / Risk prediction in patients with heart failure : A systematic review and analysis. In: JACC: Heart Failure. 2014 ; Vol. 2, No. 5. pp. 440-446.
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