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Application of the Seattle Heart Failure Model in ambulatory patients presented to an advanced heart failure therapeutics committee.

Publication ,  Journal Article
Gorodeski, EZ; Chu, EC; Chow, CH; Levy, WC; Hsich, E; Starling, RC
Published in: Circ Heart Fail
November 2010

BACKGROUND: We sought to assess the predictive value of the Seattle Heart Failure Model (SHFM) when applied to ambulatory patients with advanced heart failure (HF) presented to an advanced HF therapeutics committee at a tertiary care US institution. METHODS AND RESULTS: We evaluated model discrimination and calibration in 215 consecutive ambulatory patients who were presented to the Cleveland Clinic advanced HF therapeutics committee between 2004 to 2007 for evaluation for advanced options including transplantation and ventricular assist device (VAD). Analyses were stratified by committee decision (not listed versus listed United Network of Organ Sharing [UNOS] Status 2). Eighty-five percent had 1 or no missing SHFM variables. The primary outcome was a composite of all-cause mortality, VAD, or urgent (UNOS Status 1) transplantation. During a median follow-up of 24 months, 68 died, 18 received VAD support, and 81 underwent heart transplantation. Discrimination was modest both for those not listed (c-index, 0.683 at 1 year and 0.648 at 2 years), and for those listed UNOS status 2 (c-index, 0.629 at 1 year and 0.628 at 2 years). Calibration was acceptable among those patients not listed for heart transplantation but with substantial underestimation of risk (ie, overestimation of survival free of VAD or urgent transplantation) among UNOS status 2 patients. CONCLUSIONS: In ambulatory patients presented to an advanced HF therapeutics committee for evaluation for heart transplantation, the SHFM offers modest discrimination of risk for the primary composite outcome of mortality, VAD, or urgent transplantation, with underestimation of risk in those patients listed for nonurgent transplantation. Interpretation of risk prediction by the SHFM in this patient population must be done with caution.

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Published In

Circ Heart Fail

DOI

EISSN

1941-3297

Publication Date

November 2010

Volume

3

Issue

6

Start / End Page

706 / 714

Location

United States

Related Subject Headings

  • Risk Assessment
  • Prognosis
  • Pharmacy and Therapeutics Committee
  • Outpatients
  • Models, Statistical
  • Middle Aged
  • Male
  • Kaplan-Meier Estimate
  • Humans
  • Heart-Assist Devices
 

Citation

APA
Chicago
ICMJE
MLA
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Gorodeski, E. Z., Chu, E. C., Chow, C. H., Levy, W. C., Hsich, E., & Starling, R. C. (2010). Application of the Seattle Heart Failure Model in ambulatory patients presented to an advanced heart failure therapeutics committee. Circ Heart Fail, 3(6), 706–714. https://doi.org/10.1161/CIRCHEARTFAILURE.110.944280
Gorodeski, Eiran Z., Eric C. Chu, Chen H. Chow, Wayne C. Levy, Eileen Hsich, and Randall C. Starling. “Application of the Seattle Heart Failure Model in ambulatory patients presented to an advanced heart failure therapeutics committee.Circ Heart Fail 3, no. 6 (November 2010): 706–14. https://doi.org/10.1161/CIRCHEARTFAILURE.110.944280.
Gorodeski EZ, Chu EC, Chow CH, Levy WC, Hsich E, Starling RC. Application of the Seattle Heart Failure Model in ambulatory patients presented to an advanced heart failure therapeutics committee. Circ Heart Fail. 2010 Nov;3(6):706–14.
Gorodeski, Eiran Z., et al. “Application of the Seattle Heart Failure Model in ambulatory patients presented to an advanced heart failure therapeutics committee.Circ Heart Fail, vol. 3, no. 6, Nov. 2010, pp. 706–14. Pubmed, doi:10.1161/CIRCHEARTFAILURE.110.944280.
Gorodeski EZ, Chu EC, Chow CH, Levy WC, Hsich E, Starling RC. Application of the Seattle Heart Failure Model in ambulatory patients presented to an advanced heart failure therapeutics committee. Circ Heart Fail. 2010 Nov;3(6):706–714.

Published In

Circ Heart Fail

DOI

EISSN

1941-3297

Publication Date

November 2010

Volume

3

Issue

6

Start / End Page

706 / 714

Location

United States

Related Subject Headings

  • Risk Assessment
  • Prognosis
  • Pharmacy and Therapeutics Committee
  • Outpatients
  • Models, Statistical
  • Middle Aged
  • Male
  • Kaplan-Meier Estimate
  • Humans
  • Heart-Assist Devices