Research Article

Risk prediction model of in-hospital mortality in heart failure with preserved ejection fraction and mid-range ejection fraction: a retrospective cohort study

Department of Cardiology, Shengjing Hospital of China Medical University, 39 Huaxiang Road, Tiexi Zone, Shenyang, China

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Su Han

Department of Cardiology, Shengjing Hospital of China Medical University, 39 Huaxiang Road, Tiexi Zone, Shenyang, China

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Fei Tong

Department of Cardiology, Shengjing Hospital of China Medical University, 39 Huaxiang Road, Tiexi Zone, Shenyang, China

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Ying Li

Department of Cardiology, Shengjing Hospital of China Medical University, 39 Huaxiang Road, Tiexi Zone, Shenyang, China

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Zhi-chao Li

Department of Cardiology, Shengjing Hospital of China Medical University, 39 Huaxiang Road, Tiexi Zone, Shenyang, China

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Zhi-jun Sun

*Author for correspondence: Tel.: +86 189 4025 1218;

E-mail Address: sunzj@sj-hospital.org

https://orcid.org/0000-0003-2962-5488

Department of Cardiology, Shengjing Hospital of China Medical University, 39 Huaxiang Road, Tiexi Zone, Shenyang, China

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Published Online:9 Sep 2021https://doi.org/10.2217/bmm-2021-0025

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Abstract

Aim: To develop and validate internally a multivariate risk model for predicting the in-hospital mortality of patients with heart failure with preserved ejection fraction (HFpEF) and heart failure with mid-range ejection fraction (HFmrEF). Methods & results: The clinical data of 8172 inpatients with HFpEF and HFmrEF was used to establish a retrospective database. These patients, among whom 307 in-hospital deaths (3.8%) occurred, were randomly assigned to derivation and verification cohort. Among the extracted data from the derivation cohort were nine variables significantly related to in-hospital mortality, which were scored 0–4, for a total score of 24, which allowed formation of a risk predictive model. The verification cohort was then used to validate the discrimination and calibration capacities of this predictive model: the area under curve equaled 0.8575 (0.8285, 0.8865) for the derivation cohort, and 0.8323 (0.7999, 0.8646) for the verification cohort. According to this risk score, we divided patients into four risk classes (low-, medium-, high- and extremely high-risk) and revealed that the risk of in-hospital mortality increased with increasing risk class with an obvious linear relationship between actual and predicted mortality (r = 0.998, p < 0.001). Conclusion: The model based on nine common clinical variables should provide an accurate prediction of in-hospital mortality and appears to be a reliable risk classification system for patients with HFpEF and HFmrEF.

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Vol. 15, No. 14

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History

Received 9 January 2021

Accepted 22 June 2021

Published online 9 September 2021

Published in print October 2021

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Keywords

Author contributions

C-h Wang and Z-j Sun conceived and designed the study. C-h Wang, S Han and Y Li extracted and sorted clinical data. Z-c Li, FeiTong analyzed the data. C-he Wang and Z-j Sun wrote the paper.

Financial & competing interests disclosure

This study was supported by a grant from the Science and technology program of Liaoning Province (no. 2018225003). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The study was approved by the Ethics Committee of the Shengjing Hospital of China Medical University and was in accordance with the Declaration of Helsinki.

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