The Seattle Heart Failure Model: prediction of survival in heart failure - PubMed (original) (raw)

. 2006 Mar 21;113(11):1424-33.

doi: 10.1161/CIRCULATIONAHA.105.584102. Epub 2006 Mar 13.

Dariush Mozaffarian, David T Linker, Santosh C Sutradhar, Stefan D Anker, Anne B Cropp, Inder Anand, Aldo Maggioni, Paul Burton, Mark D Sullivan, Bertram Pitt, Philip A Poole-Wilson, Douglas L Mann, Milton Packer

Affiliations

The Seattle Heart Failure Model: prediction of survival in heart failure

Wayne C Levy et al. Circulation. 2006.

Abstract

Background: Heart failure has an annual mortality rate ranging from 5% to 75%. The purpose of the study was to develop and validate a multivariate risk model to predict 1-, 2-, and 3-year survival in heart failure patients with the use of easily obtainable characteristics relating to clinical status, therapy (pharmacological as well as devices), and laboratory parameters.

Methods and results: The Seattle Heart Failure Model was derived in a cohort of 1125 heart failure patients with the use of a multivariate Cox model. For medications and devices not available in the derivation database, hazard ratios were estimated from published literature. The model was prospectively validated in 5 additional cohorts totaling 9942 heart failure patients and 17,307 person-years of follow-up. The accuracy of the model was excellent, with predicted versus actual 1-year survival rates of 73.4% versus 74.3% in the derivation cohort and 90.5% versus 88.5%, 86.5% versus 86.5%, 83.8% versus 83.3%, 90.9% versus 91.0%, and 89.6% versus 86.7% in the 5 validation cohorts. For the lowest score, the 2-year survival was 92.8% compared with 88.7%, 77.8%, 58.1%, 29.5%, and 10.8% for scores of 0, 1, 2, 3, and 4, respectively. The overall receiver operating characteristic area under the curve was 0.729 (95% CI, 0.714 to 0.744). The model also allowed estimation of the benefit of adding medications or devices to an individual patient's therapeutic regimen.

Conclusions: The Seattle Heart Failure Model provides an accurate estimate of 1-, 2-, and 3-year survival with the use of easily obtained clinical, pharmacological, device, and laboratory characteristics.

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