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Predicting survival in heart failure: validation of the MAGGIC heart failure risk score in 51 043 patients from the Swedish Heart Failure Registry
Karolinska University Hospital, Stockholm, Sweden; Karolinska Institutet, Stockholm, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.ORCID iD: 0000-0001-6353-8041
Karolinska Institutet, Stockholm, Sweden; Karolinska University Hospital, Stockholm, Sweden.
Karolinska Institutet, Stockholm, Sweden; Karolinska University Hospital, Stockholm, Sweden.
2014 (English)In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 16, no 2, 173-179 p.Article in journal (Refereed) Published
Abstract [en]

AIMS:

The aim of this study was to evaluate the performance of a recently developed risk score for mortality in heart failure by external validation in a national heart failure registry.

METHODS AND RESULTS:

From 13 routinely available patient characteristics, the Meta-analysis Global Group in Chronic Heart Failure (MAGGIC) constructed a risk score for prediction of mortality in heart failure. We included 51 043 patients from the national Swedish Heart Failure Registry and calculated the MAGGIC risk score for each patient. The outcome measure was 3-year mortality. The predicted probability of death obtained from the calculated risk score was compared with the observed 3-year mortality, and model discrimination and calibration were assessed by formal tests and graphical means. The overall 3-year mortality in the study population was 39.4% and the MAGGIC project heart failure risk score predicted mortality was 36.4% (observed to expected ratio: 1.08). Discrimination was excellent overall (C index = 0.741). The difference between the model-predicted and the observed 3-year mortality in the six risk groups varied between 5% and -12%. Calibration plots demonstrated slight overprediction for the lowest risk patients, and underprediction in high risk patients.

CONCLUSION:

The MAGGIC project heart failure risk score demonstrated an excellent ability to categorize patients in separate risk strata. Although the predicted 3-year mortality risk was higher in low risk groups and lower in high risk groups compared with the observed 3-year mortality in the Swedish Heart Failure Registry, the MAGGIC project heart failure risk score performed well in a large nationwide contemporary external validation cohort.

Place, publisher, year, edition, pages
Oxford University Press, 2014. Vol. 16, no 2, 173-179 p.
Keyword [en]
Heart failure; Survival; Prognostic risk models; External validation
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-109151DOI: 10.1111/ejhf.32ISI: 000337628500008PubMedID: 24464911OAI: oai:DiVA.org:liu-109151DiVA: diva2:737494
Available from: 2014-08-13 Created: 2014-08-11 Last updated: 2017-12-05Bibliographically approved

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Dahlström, Ulf

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Division of Cardiovascular MedicineFaculty of Health SciencesDepartment of Cardiology in Linköping
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