Incremental utility of prognostic variables at discharge for risk prediction in hospitalized patients with acutely decompensated chronic heart failure

Domenico Scrutinio; Andrea Passantino; Pietro Guida; Enrico Ammirati; Fabrizio Oliva; Rocco Lagioia; Simona Sarzi Braga; Piergiuseppe Agostoni; Maria Frigerio

doi:10.1016/j.hrtlng.2016.03.004

Incremental utility of prognostic variables at discharge for risk prediction in hospitalized patients with acutely decompensated chronic heart failure

Domenico Scrutinio, Andrea Passantino, Pietro Guida, Enrico Ammirati, Fabrizio Oliva, Rocco Lagioia, Simona Sarzi Braga, Piergiuseppe Agostoni, Maria Frigerio

Research output: Contribution to journal › Article › peer-review

Abstract

Objectives: To assess the incremental prognostic utility of discharge serum creatinine (SCr), systolic blood pressure (SBP), and NT-proBNP and sodium concentrations in hospitalized patients with acutely decompensated chronic heart failure. Background: Whether key prognostic variables at discharge provide incremental prognostic information beyond that provided by a model based on admission variables (referent) remains incompletely defined. Methods: The primary outcome was a composite of death, urgent heart transplantation, or ventricular assist device implantation at 1 year. The gain in predictive performance was assessed using C index, Bayesian Information Criterion, and Net Reclassification Improvement. Results: The best fit was obtained when discharge NT-proBNP was added to the referent model. No interaction between admission and discharge NT-proBNP was found. Discharge SCr, SBP, and sodium did not improve goodness-of-fit. Conclusions: Admission and discharge NT-proBNP provide complementary and independent prognostic information; as such, they should be taken into account concurrently.

Original language	English
Pages (from-to)	212-219
Number of pages	8
Journal	Heart and Lung: Journal of Acute and Critical Care
Volume	45
Issue number	3
DOIs	https://doi.org/10.1016/j.hrtlng.2016.03.004
Publication status	Published - May 1 2016

Keywords

Acutely decompensated chronic heart failure
Admission N-terminal Pro-B-Type natriuretic peptide
Discharge N-terminal Pro-B-Type natriuretic peptide
Prognosis
Risk stratification

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Critical Care and Intensive Care Medicine
Pulmonary and Respiratory Medicine

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Scrutinio, D., Passantino, A., Guida, P., Ammirati, E., Oliva, F., Lagioia, R., Sarzi Braga, S., Agostoni, P., & Frigerio, M. (2016). Incremental utility of prognostic variables at discharge for risk prediction in hospitalized patients with acutely decompensated chronic heart failure. Heart and Lung: Journal of Acute and Critical Care, 45(3), 212-219. https://doi.org/10.1016/j.hrtlng.2016.03.004

Incremental utility of prognostic variables at discharge for risk prediction in hospitalized patients with acutely decompensated chronic heart failure. / Scrutinio, Domenico; Passantino, Andrea; Guida, Pietro; Ammirati, Enrico; Oliva, Fabrizio; Lagioia, Rocco; Sarzi Braga, Simona; Agostoni, Piergiuseppe; Frigerio, Maria.

In: Heart and Lung: Journal of Acute and Critical Care, Vol. 45, No. 3, 01.05.2016, p. 212-219.

Research output: Contribution to journal › Article › peer-review

Scrutinio, D, Passantino, A, Guida, P, Ammirati, E, Oliva, F, Lagioia, R, Sarzi Braga, S, Agostoni, P & Frigerio, M 2016, 'Incremental utility of prognostic variables at discharge for risk prediction in hospitalized patients with acutely decompensated chronic heart failure', Heart and Lung: Journal of Acute and Critical Care, vol. 45, no. 3, pp. 212-219. https://doi.org/10.1016/j.hrtlng.2016.03.004

Scrutinio, Domenico ; Passantino, Andrea ; Guida, Pietro ; Ammirati, Enrico ; Oliva, Fabrizio ; Lagioia, Rocco ; Sarzi Braga, Simona ; Agostoni, Piergiuseppe ; Frigerio, Maria. / Incremental utility of prognostic variables at discharge for risk prediction in hospitalized patients with acutely decompensated chronic heart failure. In: Heart and Lung: Journal of Acute and Critical Care. 2016 ; Vol. 45, No. 3. pp. 212-219.

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abstract = "Objectives: To assess the incremental prognostic utility of discharge serum creatinine (SCr), systolic blood pressure (SBP), and NT-proBNP and sodium concentrations in hospitalized patients with acutely decompensated chronic heart failure. Background: Whether key prognostic variables at discharge provide incremental prognostic information beyond that provided by a model based on admission variables (referent) remains incompletely defined. Methods: The primary outcome was a composite of death, urgent heart transplantation, or ventricular assist device implantation at 1 year. The gain in predictive performance was assessed using C index, Bayesian Information Criterion, and Net Reclassification Improvement. Results: The best fit was obtained when discharge NT-proBNP was added to the referent model. No interaction between admission and discharge NT-proBNP was found. Discharge SCr, SBP, and sodium did not improve goodness-of-fit. Conclusions: Admission and discharge NT-proBNP provide complementary and independent prognostic information; as such, they should be taken into account concurrently.",

keywords = "Acutely decompensated chronic heart failure, Admission N-terminal Pro-B-Type natriuretic peptide, Discharge N-terminal Pro-B-Type natriuretic peptide, Prognosis, Risk stratification",

author = "Domenico Scrutinio and Andrea Passantino and Pietro Guida and Enrico Ammirati and Fabrizio Oliva and Rocco Lagioia and {Sarzi Braga}, Simona and Piergiuseppe Agostoni and Maria Frigerio",

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AU - Scrutinio, Domenico

AU - Passantino, Andrea

AU - Guida, Pietro

AU - Ammirati, Enrico

AU - Oliva, Fabrizio

AU - Lagioia, Rocco

AU - Sarzi Braga, Simona

AU - Agostoni, Piergiuseppe

AU - Frigerio, Maria

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N2 - Objectives: To assess the incremental prognostic utility of discharge serum creatinine (SCr), systolic blood pressure (SBP), and NT-proBNP and sodium concentrations in hospitalized patients with acutely decompensated chronic heart failure. Background: Whether key prognostic variables at discharge provide incremental prognostic information beyond that provided by a model based on admission variables (referent) remains incompletely defined. Methods: The primary outcome was a composite of death, urgent heart transplantation, or ventricular assist device implantation at 1 year. The gain in predictive performance was assessed using C index, Bayesian Information Criterion, and Net Reclassification Improvement. Results: The best fit was obtained when discharge NT-proBNP was added to the referent model. No interaction between admission and discharge NT-proBNP was found. Discharge SCr, SBP, and sodium did not improve goodness-of-fit. Conclusions: Admission and discharge NT-proBNP provide complementary and independent prognostic information; as such, they should be taken into account concurrently.

AB - Objectives: To assess the incremental prognostic utility of discharge serum creatinine (SCr), systolic blood pressure (SBP), and NT-proBNP and sodium concentrations in hospitalized patients with acutely decompensated chronic heart failure. Background: Whether key prognostic variables at discharge provide incremental prognostic information beyond that provided by a model based on admission variables (referent) remains incompletely defined. Methods: The primary outcome was a composite of death, urgent heart transplantation, or ventricular assist device implantation at 1 year. The gain in predictive performance was assessed using C index, Bayesian Information Criterion, and Net Reclassification Improvement. Results: The best fit was obtained when discharge NT-proBNP was added to the referent model. No interaction between admission and discharge NT-proBNP was found. Discharge SCr, SBP, and sodium did not improve goodness-of-fit. Conclusions: Admission and discharge NT-proBNP provide complementary and independent prognostic information; as such, they should be taken into account concurrently.

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Incremental utility of prognostic variables at discharge for risk prediction in hospitalized patients with acutely decompensated chronic heart failure

Abstract

Keywords

ASJC Scopus subject areas

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