Publication

The COACH risk engine: a multistate model for predicting survival and hospitalization in patients with heart failure

Postmus, D., van Veldhuisen, D. J., Jaarsma, T., Luttik, M. L., Lassus, J., Mebazaa, A., Nieminen, M. S., Harjola, V-P., Lewsey, J., Buskens, E. & Hillege, H. L., Feb-2012, In : European Journal of Heart Failure. 14, 2, p. 168-175 8 p.

Research output: Contribution to journalArticleAcademicpeer-review

Copy link to clipboard

Documents

DOI

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.

Methods 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 model's accuracy in predicting HF hospitalization was excellent, with predicted values that closely resembled the values observed in the derivation cohort.

Conclusion 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.

Original languageEnglish
Pages (from-to)168-175
Number of pages8
JournalEuropean Journal of Heart Failure
Volume14
Issue number2
Publication statusPublished - Feb-2012

    Keywords

  • Epidemiology, Heart failure, Prediction, Prognosis, Multistate modelling, PRESERVED SYSTOLIC FUNCTION, PROGNOSTIC MODELS, ADHERE DATABASE, PULSE PRESSURE, OPTIMIZE-HF, MORTALITY, OUTCOMES, SCORE, DYSFUNCTION, MANAGEMENT

View graph of relations

Download statistics

No data available

ID: 5486384