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The prognosis of patients hospitalized with a first episode of heart failure, validation of two scores: PREDICE and AHEAD

Clinical Epidemiology Jul 28, 2019

Ruiz-Ruiz F, et al. - A prospective multicenter cohort study which involved 180 subjects hospitalized with “de novo” heart failure (HF, a chronic, frequent and disabling condition but with a modifiable course and a large potential for getting better) was done by the researchers in order to verify the two available clinical prognostication rules for mortality at one year in subjects with primo-hospitalization for decompensated HF, ie, PREDICE and AHEAD and to assess the variations in the clinical pattern of HF in the last decade in subjects hospitalized for a first episode of the disease. The area under the curve (AUC) and the calibration slope were 0.68 and 0.65, respectively, for the PREDICE models whereas, for the PREDICE score, AUC and slope was 0.59 and 0.42, respectively. When used the development cohort of PREDICE and when used its validation cohort, the AUC was 0.68 and 0.58 and the slope was 1.38 and 0.68, respectively for the AHEAD score. Hence, the two risk scores available for subjects with primo-hospitalization for decompensated HF (PREDICE and AHEAD) were not concluded to be currently efficient for prognosticating mortality at one-year. The clinical spectrum of hospitalized subjects with new-onset HF had been altered over time. Moreover, the study underscored the necessity to verify the prognostic models prior to the clinical implementation.
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