Added value of frailty and social support in predicting risk of 30-day unplanned re-admission or death for patients with heart failure: An analysis from OPERA-HF

• Published in: International journal of cardiology 2019-03, Vol.278, p.167-172
• Main Authors: Sokoreli, I., Cleland, J.G., Pauws, S.C., Steyerberg, E.W., de Vries, J.J.G., Riistama, J.M., Dobbs, K., Bulemfu, J., Clark, A.L.
• Format: Article
• Language: English
• Subjects: 30-day re-admission; Frailty; Heart failure; Mortality; Psychosocial factors
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2018.12.030

Models for predicting the outcome of patients hospitalized for heart failure (HF) rarely take a holistic view. We assessed the ability of measures of frailty and social support in addition to demographic, clinical, imaging and laboratory variables to predict short-term outcome for patients discharged after a hospitalization for HF. OPERA-HF is a prospective observational cohort, enrolling patients hospitalized for HF in a single center in Hull, UK. Variables were combined in a logistic regression model after multiple imputation of missing data to predict the composite outcome of death or readmission at 30 days. Comparisons were made to a model using clinical variables alone. The discriminative performance of each model was internally validated with bootstrap re-sampling. 1094 patients were included (mean age 77 [interquartile range 68–83] years; 40% women; 56% with moderate to severe left ventricular systolic dysfunction) of whom 213 (19%) had an unplanned re-admission and 60 (5%) died within 30 days. For the composite outcome, a model containing clinical variables alone had an area under the receiver-operating characteristic curve (AUC) of 0.68 [95% CI 0.64–0.72]. Adding marital status, support from family and measures of physical frailty increased the AUC (p