A simple validated method for predicting the risk of hospitalization for worsening of heart failure in ambulatory patients : the Redin-SCORE

Abstract

Prevention of hospital readmissions is one of the main objectives in the management of patients with heart failure (). Most of the models predicting readmissions are based on data extracted from hospitalized patients rather than from outpatients. Our objective was to develop a validated score predicting 1-month and 1-year risk of readmission for worsening of in ambulatory patients. A cohort of 2507 ambulatory patients with chronic was prospectively followed for a median of 3.3 years. Clinical, echocardiographic, , and biochemical variables were used in a competing risk regression analysis to construct a risk score for readmissions due to worsening of . Thereafter, the score was externally validated using a different cohort of 992 patients with chronic ( registry). Predictors of 1-month readmission were the presence of elevated natriuretic peptides, left ventricular (LV) HF signs, and estimated glomerular filtration rate () <60 /min/m 2. Predictors of 1-year readmission were elevated natriuretic peptides, anaemia, left atrial size >26 mm/m 2, heart rate >70 b.p.m., signs, and <60 /min/m 2. The C-statistics for the models were 0.72 and 0.66, respectively. The cumulative incidence function distinguished low-risk (<1% event rate) and high-risk groups (>5% event rate) for 1-month readmission. Likewise, low-risk (7.8%), intermediate-risk (15.6%) and high-risk groups (26.1%) were identified for 1-year readmission risk. The C-statistics remained consistent after the external validation (<5% loss of discrimination). The Redin- predicts early and late readmission for worsening of using proven prognostic variables that are routinely collected in outpatient management of chronic.