STUDY OBJECTIVE: Validate a clinical prediction rule prognostic of short-term fatal and inpatient nonfatal outcomes for heart failure patients admitted through the emergency department. METHODS: We retrospectively studied a random cohort of 8,384 adult patients admitted to Pennsylvania hospitals in 2003 and 2004 with a diagnosis of heart failure as defined by primary discharge diagnosis codes. We reported the proportions of inpatient death, serious medical complications before discharge, and 30-day death in the patients identified as low risk by the prediction rule. RESULTS: The prediction rule classified 1,609 (19.2%) of the patients as low risk. Within this subgroup, there were 12 (0.7%; 95% confidence interval [CI] 0.3% to 1.2%) inpatient deaths, 28 (1.7%; 95% CI 1.1% to 2.4%) patients survived to hospital discharge after a serious complication, and 47 (2.9%; 95% CI 2.1% to 3.7%) patients died within 30 days of the index hospitalization. CONCLUSION: This prediction rule identifies a group of admitted heart failure patients at low risk of inpatient mortal and nonmortal complications. Our validation findings suggest the rule could assist physicians in making site-of-care decisions for this patient population and aid in analyzing presenting illness burden in study populations.
STUDY OBJECTIVE: Validate a clinical prediction rule prognostic of short-term fatal and inpatient nonfatal outcomes for heart failurepatients admitted through the emergency department. METHODS: We retrospectively studied a random cohort of 8,384 adult patients admitted to Pennsylvania hospitals in 2003 and 2004 with a diagnosis of heart failure as defined by primary discharge diagnosis codes. We reported the proportions of inpatient death, serious medical complications before discharge, and 30-day death in the patients identified as low risk by the prediction rule. RESULTS: The prediction rule classified 1,609 (19.2%) of the patients as low risk. Within this subgroup, there were 12 (0.7%; 95% confidence interval [CI] 0.3% to 1.2%) inpatient deaths, 28 (1.7%; 95% CI 1.1% to 2.4%) patients survived to hospital discharge after a serious complication, and 47 (2.9%; 95% CI 2.1% to 3.7%) patients died within 30 days of the index hospitalization. CONCLUSION: This prediction rule identifies a group of admitted heart failurepatients at low risk of inpatient mortal and nonmortal complications. Our validation findings suggest the rule could assist physicians in making site-of-care decisions for this patient population and aid in analyzing presenting illness burden in study populations.
Authors: Clare L Atzema; Peter C Austin; Bing Yu; Michael J Schull; Cynthia A Jackevicius; Noah M Ivers; Paula A Rochon; Douglas S Lee Journal: CMAJ Date: 2018-12-17 Impact factor: 8.262
Authors: Jeremiah D Schuur; Christopher W Baugh; Erik P Hess; Joshua A Hilton; Jesse M Pines; Brent R Asplin Journal: Acad Emerg Med Date: 2011-06 Impact factor: 3.451
Authors: Sean Collins; Alan B Storrow; Nancy M Albert; Javed Butler; Justin Ezekowitz; G Michael Felker; Gregory J Fermann; Gregg C Fonarow; Michael M Givertz; Brian Hiestand; Judd E Hollander; David E Lanfear; Phillip D Levy; Peter S Pang; W Frank Peacock; Douglas B Sawyer; John R Teerlink; Daniel J Lenihan Journal: J Card Fail Date: 2014-07-18 Impact factor: 5.712