The COACH risk engine: a multistate model for predicting survival and hospitalization in patients with heart failure
2012 (English)In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 14, no 2, 168-175 p.Article in journal (Refereed) Published
Aims Several models for predicting the prognosis of heart failure (HF) patients have been developed, but all of them focus on a single outcome variable, such as all-cause mortality. The purpose of this study was to develop a multistate model for simultaneously predicting survival and HF-related hospitalization in patients discharged alive from hospital after recovery from acute HF. less thanbrgreater than less thanbrgreater thanMethods and results The model was derived in the COACH (Coordinating Study Evaluating Outcomes of Advising and Counseling in Heart Failure) cohort, a multicentre, randomized controlled trial in which 1023 patients were enrolled after hospitalization because of HF. External validation was attained with the FINN-AKVA (Finish Acute Heart Failure Study) cohort, a prospective, multicentre study with 620 patients hospitalized due to acute HF. The observed vs. predicted 18-month survival was 72.1% vs. 72.3% in the derivation cohort and 71.4% vs. 71.2% in the validation cohort. The corresponding values of the c statistic were 0.733 [95% confidence interval (CI) 0.705-0.761] and 0.702 (95% CI 0.663-0.744), respectively. The models accuracy in predicting HF hospitalization was excellent, with predicted values that closely resembled the values observed in the derivation cohort. less thanbrgreater than less thanbrgreater thanConclusion The COACH risk engine accurately predicted survival and various measures of recurrent hospitalization in (acute) HF patients. It may therefore become a valuable tool in improving and personalizing patient care and optimizing the use of scarce healthcare resources.
Place, publisher, year, edition, pages
Oxford University Press (OUP): Policy B , 2012. Vol. 14, no 2, 168-175 p.
Epidemiology, Heart failure, Prediction, Prognosis, Multistate modelling
National CategoryMedical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-75105DOI: 10.1093/eurjhf/hfr163ISI: 000299350800010OAI: oai:DiVA.org:liu-75105DiVA: diva2:504553
Funding Agencies|Center for Translational Molecular Medicine (CTMM)|01C-103|Dutch Heart Foundation|2000Z003D97.017|Novartis (Arnhem, The Netherlands)||2012-02-212012-02-172012-03-01