scholarly journals A Nomogram based on a Patient-reported Outcomes Measure: Predicting the Risk of Readmission for Patients with Chronic Heart Failure

2020 ◽  
Author(s):  
qiang han ◽  
Jing Tian ◽  
Hong Yang ◽  
Qing Zhang ◽  
Ruoya Wang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Patient Reported Outcomes ◽  
Cox Regression ◽  
Predictive Accuracy ◽  
Measurement Tool ◽  
Concordance Index ◽  
Discriminative Ability ◽  
Cox Regression Analysis ◽  
Patient Reported

Abstract Background Health-related quality of life, evaluated by a patient-reported outcomes measure, is an important prognostic marker in patients with chronic heart failure. This study aimed to use PROM to establish an effective readmission nomogram for chronic heart failure. Methods Using patient-reported outcomes measure as a measurement tool, we conducted a readmission nomogram for chronic heart failure on a prospective observational study comprising 454 patients with chronic heart failure hospitalized between May 2017 to January 2020. Concordance index and calibration curve were used to evaluate the discriminative ability and predictive accuracy of the nomogram. A bootstrap resampling method was used for internal validation of results. Results The median follow-up period in the study was 197 days. After a final COX regression analysis, the computed gender, income, health care, appetite-sleep, anxiety, depression, paranoia, support, and independence were identified and included in the nomogram. The nomogram showed moderate discrimination, with concordance index of 0.737 (95% CI 0.673-0.800). The calibration curves for the probability of readmission for patients with chronic heart failure showed high consistency between the probability, as predicted, and the actual probability. Conclusions This model offers a platform to assess the risk of readmission for different populations with CHF and can assist clinicians with personalized treatment recommendations.

scholarly journals A Nomogram based on a Patient-reported Outcomes Measure: Predicting the Risk of Readmission for Patients with Chronic Heart Failure

2020 ◽  
Author(s):  
Qiang Han ◽  
Jia Ren ◽  
Jing Tian ◽  
Hong Yang ◽  
Qing Zhang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Patient Reported Outcomes ◽  
Cox Regression ◽  
Predictive Accuracy ◽  
Measurement Tool ◽  
Concordance Index ◽  
Discriminative Ability ◽  
Cox Regression Analysis ◽  
Patient Reported

Abstract Background Health-related quality of life, evaluated by a patient-reported outcomes measure, is an important prognostic marker in patients with chronic heart failure. This study aimed to use PROM to establish an effective readmission nomogram for chronic heart failure. Methods Using patient-reported outcomes measure as a measurement tool, we conducted a readmission nomogram for chronic heart failure on a prospective observational study comprising 454 patients with chronic heart failure hospitalized between May 2017 to January 2020. Concordance index and calibration curve were used to evaluate the discriminative ability and predictive accuracy of the nomogram. A bootstrap resampling method was used for internal validation of results. Results The median follow-up period in the study was 372 days. After a final COX regression analysis, the gender, income, health care, appetite-sleep, anxiety, depression, paranoia, support, and independence were identified and included in the nomogram. The nomogram showed moderate discrimination, with concordance index of 0.737 (95% CI 0.673-0.800). The calibration curves for the probability of readmission for patients with chronic heart failure showed high consistency between the probability, as predicted, and the actual probability. Conclusions This model offers a platform to assess the risk of readmission for different populations with CHF and can assist clinicians with personalized treatment recommendations.

scholarly journals A Nomogram based on a Patient-reported Outcomes Measure: Predicting the Risk of Readmission for Patients with Chronic Heart Failure

2020 ◽  
Author(s):  
Qiang Han ◽  
Jia Ren ◽  
Jing Tian ◽  
Hong Yang ◽  
Qing Zhang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Patient Reported Outcomes ◽  
Cox Regression ◽  
Predictive Accuracy ◽  
Measurement Tool ◽  
Concordance Index ◽  
Discriminative Ability ◽  
Cox Regression Analysis ◽  
Patient Reported

Abstract Background Health-related quality of life, evaluated by a patient-reported outcomes measure, is an important prognostic marker in patients with chronic heart failure. This study aimed to use PROM to establish an effective readmission nomogram for chronic heart failure. Methods Using patient-reported outcomes measure as a measurement tool, we conducted a readmission nomogram for chronic heart failure on a prospective observational study comprising 454 patients with chronic heart failure hospitalized between May 2017 to January 2020. Concordance index and calibration curve were used to evaluate the discriminative ability and predictive accuracy of the nomogram. A bootstrap resampling method was used for internal validation of results. Results The median follow-up period in the study was 372 days. After a final COX regression analysis, the gender, income, health care, appetite-sleep, anxiety, depression, paranoia, support, and independence were identified and included in the nomogram. The nomogram showed moderate discrimination, with concordance index of 0.737 (95% CI 0.673-0.800). The calibration curves for the probability of readmission for patients with chronic heart failure showed high consistency between the probability, as predicted, and the actual probability. Conclusions This model offers a platform to assess the risk of readmission for different populations with CHF and can assist clinicians with personalized treatment recommendations.

scholarly journals Patient-Reported Outcomes in Chronic Heart Failure

2016 ◽  
Vol 4 (10) ◽  
pp. 791-804 ◽  
Author(s):  
Mitchell A. Psotka ◽  
Robyn von Maltzahn ◽  
Milena Anatchkova ◽  
Irene Agodoa ◽  
Dina Chau ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Patient Reported Outcomes ◽  
Patient Reported

scholarly journals Plasma IL-37 Elevated in Patients with Chronic Heart Failure and Predicted Major Adverse Cardiac Events: A 1-Year Follow-Up Study

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Xiling Shou ◽  
Jing Lin ◽  
Cui Xie ◽  
Yi Wang ◽  
Chaofeng Sun
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Cox Regression ◽  
Left Ventricular ◽  
Major Adverse Cardiac Events ◽  
Left Ventricular Ejection ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cardiac Events ◽  
Cox Regression Analysis ◽  
Adverse Cardiac Events

A great number of basic and clinical studies have demonstrated that inflammatory cytokines play an important role in the development and progression of chronic heart failure (CHF). However, there is limited information about the role of novel cytokine interleukin-37 (IL-37) in heart failure. We measured plasma IL-37 levels by enzyme-linked immunosorbent assay (ELISA) in 158 patients with chronic heart failure and 30 control subjects. Our results showed that plasma IL-37 levels were significantly elevated in patients with CHF compared with healthy controls (143.73 ± 26.83 pg/ml versus 45.2 ± 11.56 pg/ml,P<0.001). Furthermore, plasma IL-37 levels were positively correlated with hs-CRP, hs-TnT, and NT-proBNP and negatively correlated with left ventricular ejection function (LVEF). 11 patients died of cardiovascular cause, and 27 HF patients were rehospitalized for worsening HF within 12 months. Multivariate Cox regression analysis showed that plasma IL-37 is an independent predictor of major adverse cardiac events (MACE). Furthermore, CHF patients with >99 pg/ml plasma IL-37 had significantly higher incidences of MACE within 12 months. Our data suggest that plasma IL-37 may play a role in the pathogenesis of CHF and may be a novel predictor of poor prognosis in HF patients.

scholarly journals Relationship between changing patient-reported outcomes and subsequent clinical events in patients with chronic heart failure: insights from HF-ACTION

2018 ◽  
Vol 21 (1) ◽  
pp. 63-70 ◽  
Author(s):  
Nancy Luo ◽  
Christopher M. O'Connor ◽  
Lauren B. Cooper ◽  
Jie-Lena Sun ◽  
Adrian Coles ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Patient Reported Outcomes ◽  
Clinical Events ◽  
Patient Reported

scholarly journals Influence of self-management on patient-reported outcomes for individuals with chronic heart failure: a multilevel model approach from a longitudinal study

2020 ◽  
Author(s):  
Jing Tian ◽  
Jinghua Zhao ◽  
Qing Zhang ◽  
Jia Ren ◽  
Linai Han ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Patient Reported Outcomes ◽  
Multilevel Models ◽  
Management Strategies ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Self Management ◽  
Converting Enzyme Inhibitors ◽  
Patient Reported ◽  
Improve Patient

Abstract Purpose: Self-management is highly heterogenous in patient-reported outcomes in individuals with chronic heart failure and lacks a clinical definition. The aim of this study was to identify clinically meaningful strategies that improve patient-reported outcomes in those with chronic heart failure.Methods: A multicenter, prospective cohort study of 555 patients with heart failure were enrolled from May 2017 to May 2019. Self-management advice was provided in written form at discharge. Information regarding chronic heart failure in patient-reported outcomes and self-management was collected during follow-up. Multilevel models were applied to dynamically evaluate the effects of self-management strategies for patient-reported outcome of chronic heart failure (CHF-PRO) scores, as well as its physical and psychological domains. Minimal clinically important difference was introduced to further evaluate clinical significance.Results: Scores for CHF-PRO improved significantly after discharge. A regular schedule, avoidance of over-eating, and a low-sodium diet increased scores on patient-reported outcomes, including overall scores and physical and psychological scores. In addition, exercise improved patient-reported outcomes and its physical domain. The use of angiotensin-converting enzyme inhibitors also increased physical scores. Among these variables, a regular daily schedule and avoidance of over-eating almost every day reached clinical significance for CHF-PRO scores, as well as its physical and psychological domains.Conclusions: Self-management, especially the avoidance of over-eating and maintenance of a regular schedule, should be implemented to improve patient-reported outcomes in those with chronic heart failure.Trial registration: 2018LL128, January 2, 2018.

scholarly journals Influence of self-management on patient-reported outcomes for individuals with chronic heart failure: a multilevel model approach from a longitudinal study

2020 ◽  
Author(s):  
Jing Tian ◽  
Jinghua Zhao ◽  
Qing Zhang ◽  
Jia Ren ◽  
Linai Han ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Clinical Significance ◽  
Patient Reported Outcomes ◽  
Multilevel Models ◽  
Management Strategies ◽  
Self Management ◽  
Converting Enzyme Inhibitors ◽  
Patient Reported ◽  
Improve Patient

Abstract Purpose: Self-management is highly heterogenous in patient-reported outcomes in individuals with chronic heart failure and lacks a clinical definition. The aim of this study was to identify clinically meaningful strategies that improve patient-reported outcomes in those with chronic heart failure. Methods: A total of 555 patients with heart failure were enrolled. Self-management advice was provided in written form at discharge. Information regarding chronic heart failure in patient-reported outcomes and self-management was collected during follow-up. Multilevel models were applied to evaluate the effects of self-management strategies for patient-reported outcome of chronic heart failure (CHF-PRO) scores, as well as its physical and psychological domains. Minimal clinically important difference was introduced to further evaluate clinical significance. Results: Scores for CHF-PRO improved significantly after discharge. A regular schedule, avoidance of over-eating, and a low-sodium diet increased scores on patient-reported outcomes, including overall scores and physical and psychological scores. In addition, exercise improved patient-reported outcomes and its physical domain. The use of angiotensin-converting enzyme inhibitors also increased physical scores. Among these variables, a regular daily schedule and avoidance of over-eating almost every day reached clinical significance for CHF-PRO scores, as well as its physical and psychological domains. Conclusions: Self-management, especially the avoidance of over-eating and maintenance of a regular schedule, should be implemented to improve patient-reported outcomes in those with chronic heart failure.

scholarly journals Propensity for Calcification in Serum Associates With 2-Year Cardiovascular Mortality in Ischemic Heart Failure With Reduced Ejection Fraction

2021 ◽  
Vol 8 ◽  
Author(s):  
Marija Bojic ◽  
Lorenz Koller ◽  
Daniel Cejka ◽  
Alexander Niessner ◽  
Bernhard Bielesz
Keyword(s):  
Heart Failure ◽  
Regression Analysis ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Cardiovascular Mortality ◽  
Cox Regression ◽  
Fibroblast Growth Factor 23 ◽  
Cox Regression Analysis ◽  
Reduced Ejection Fraction ◽  
Fgf 23

Background: The propensity of serum to calcify, as assessed by the T50-test, associates with mortality in patients with chronic kidney disease. In chronic heart failure, phosphate and fibroblast growth factor-23 (FGF-23), which are important components of the vascular calcification pathway, have been linked to patient survival. Here, we investigated whether T50 associates with overall and cardiovascular survival in patients with chronic heart failure with reduced ejection fraction (HFrEF).Methods: We measured T50, intact and c-terminal FGF-23 levels in a cohort of 306 HFrEF patients. Associations with overall and cardiovascular mortality were analyzed in survival analysis and Cox-regression models.Results: After a median follow-up time of 3.2 years (25th−75th percentile: 2.0–4.9 years), 114 patients (37.3%) died due to any cause and 76 patients (24.8%) died due to cardiovascular causes. 139 patients (45.4%) had ischemic and 167 patients (54.6%) had non-ischemic HFrEF. Patients with ischemic HFrEF in the lowest T50-tertile had significantly greater 2-year cardiovascular mortality compared to patients in higher tertiles (p = 0.011). In ischemic but not in non-ischemic HFrEF, T50 was significantly associated with cardiovascular mortality in univariate (p = 0.041) and fully adjusted (p = 0.046) Cox regression analysis. Significant associations of intact and c-terminal FGF-23 with all-cause and cardiovascular mortality in univariate Cox regression analysis did not remain significant after adjustment for confounding factors.Conclusion: T50 is associated with 2-year cardiovascular mortality in patients with ischemic HFrEF but not in non-ischemic HFrEF. More research on the role of T50 measurements in coronary artery disease is warranted.

scholarly journals Recent advances in the treatment of chronic heart failure

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 2134 ◽  
Author(s):  
Leo F Buckley ◽  
Amil M Shah
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Patient Reported Outcomes ◽  
Cardiovascular Death ◽  
Functional Mitral Regurgitation ◽  
Heart Failure Hospitalization ◽  
Shift Trial ◽  
Patient Reported ◽  
Therapeutic Development ◽  
Remote Hemodynamic Monitoring

After more than a decade of relatively modest advancements, heart failure therapeutic development has accelerated, with the PARADIGM-HF trial and the SHIFT trial demonstrated significant reductions in cardiovascular death and heart failure hospitalization for sacubitril-valsartan and in heart failure hospitalization alone for ivabradine. Several heart failure therapies have since received or stand on the verge of market approval and promise substantive advances in the treatment of chronic heart failure. Some of these improve clinical outcomes, whereas others improve functional or patient-reported outcomes. In light of these rapid advances in the care of adults living with chronic heart failure, in this review we seek to update the general practitioner on novel heart failure therapies. Specifically, we will review recent data on the implementation of sacubitril-valsartan, treatment of functional mitral regurgitation, sodium-glucose co-transporter-2 (SGLT-2) inhibitor therapy, agents for transthyretin amyloid cardiomyopathy, treatment of iron deficiency in heart failure, and the use of biomarkers or remote hemodynamic monitoring to guide heart failure therapy.

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