Predicting hospitalization and mortality in patients with heart failure: The BARDICHE-index. (15th January 2017)

• Record Type: Journal Article
• Authors: Uszko-Lencer, Nicole H.M.K.; Frankenstein, Lutz; Spruit, Martijn A.; Maeder, Micha T.; Gutmann, Marc; Muzzarelli, Stefano; Osswald, Stefan; Pfisterer, Matthias E.; Zugck, Christian; Brunner-La Rocca, Hans-Peter
• Is Part Of: International journal of cardiology. Volume 227(2017)
• Page Start: 901
• Page End: 907
• Publication Date: 2017-01-15
• Subjects: Chronic heart failure -- Prognostic model -- Survival; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2016.11.122
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: Prediction of events in chronic heart failure (CHF) patients is still difficult and available scores are often complex to calculate. Therefore, we developed and validated a simple-to-use, multidimensional prognostic index for such patients. Methods: A theoretical model was developed based on known prognostic factors of CHF that are easily obtainable: Body mass index (B), Age (A), Resting systolic blood pressure (R), Dyspnea (D), N-termInal pro brain natriuretic peptide (NT-proBNP) (I), Cockroft-Gault equation to estimate glomerular filtration rate (C), resting Heart rate (H), and Exercise performance using the 6-min walk test (E) (the BARDICHE-index). Scores were given for all components and added, the sum ranging from 1 (lowest value) to 25 points (maximal value), with estimated risk being highest in patients with highest scores. Scores were categorized into three groups: a low (≤ 8 points); medium (9–16 points), or high (> 16 points) BARDICHE-score. The model was validated in a data set of 1811 patients from two prospective CHF-cohorts (median follow-up 887 days). The primary outcome was 5-year all-cause survival. Secondary outcomes were 5-year survival without all-cause hospitalization and 5-year survival without CHF-related hospitalization. Results: There were significant differences between BARDICHE-risk groups for mortality (hazard ratio = 3.63 per BARDICHE-group, 95%-CI 3.10–4.25), mortality or all-cause hospitalization (HR = 2.00 per BARDICHE-group, 95%-CI 1.83–2.19), and mortality or CHF-related hospitalization (HR = 3.43 per BARDICHE-group, 95%-CI 3.01–3.92; all P < 10–50). Outcome was predicted independently of left ventricular ejection fraction (LVEF) and gender. Conclusions: The BARDICHE-index is a simple multidimensional prognostic tool for patients with CHF, independently of LVEF.