Risk of in-hospital mortality identified according to the typology of patients with acute heart failure: Classification tree analysis on data from the Acute Heart Failure Database-Main registry

Authors	TOMČÍKOVÁ Daniela FELŠŐCI Marián ŠPINAR Jindřich MIKLÍK Roman MIKUŠOVÁ Tereza VÍTOVEC Jiří ŠPINAROVÁ Lenka WIDIMSKÝ Petr LINHART Ales BĚLOHLÁVEK Jan FEDORCO Marian ČIHALÍK Čestmír MÁLEK Filip BAMBUCH Miroslav VACLAVIK Jan KETTNER Jiří JARKOVSKÝ Jiří DUŠEK Ladislav PAŘENICA Jiří
Year of publication	2013
Type	Article in Periodical
Magazine / Source	Journal of Critical Care
MU Faculty or unit	Faculty of Medicine
Citation
Doi	http://dx.doi.org/10.1016/j.jcrc.2012.09.014
Field	Cardiovascular diseases incl. cardiosurgery
Keywords	Acute heart failure; Classification tree; In-hospital mortality; AHEAD
Attached files	Risk.pdf
Description	Purpose: The purposes of this study are to identify the strongest clinical parameters in relation to in-hospital mortality, which are available in the earliest phase of the hospitalization of patients, and to create an easy tool for the early identification of patients at risk. Materials and Methods: The classification and regression tree analysis was applied to data from the Acute Heart Failure Database-Main registry comprising patients admitted to specialized cardiology centers with all syndromes of acute heart failure. The classification model was built on derivation cohort (n = 2543) and evaluated on validation cohort (n = 1387). Results: The classification tree stratifies patients according to the presence of cardiogenic shock (CS), the level of creatinine, and the systolic blood pressure (SBP) at admission into the 5 risk groups with in-hospital mortality ranging from 2.8% to 66.2%. Patients without CS and creatinine level of 155 mu mol/L or less were classified into very-low-risk group; patients without CS, creatinine level greater than 155 mu mol/L, and SBP greater than 103 mm Hg, into low-risk group, whereas patients without CS, creatinine level greater than 155 mu mol/L, and SBP of 103 mm Hg or lower, into intermediate-risk group. The high-risk group patients had CS and creatinine of 140 mu mol/L or less; patients with CS and creatinine level greater than 140 mu mol/L belong to very-high-risk group. The area under receiver operating characteristic curve was 0.823 and 0.832, and the value of Brier's score was estimated on level 0.091 and 0.084, for the derivation and the validation cohort, respectively.