Validation of the Intermountain Risk Score and Get with the Guidelines—Heart Failure Score in predicting mortality
Objective The Intermountain Risk Score (IMRS) was evaluated for validation as a mortality predictor and compared with the American Heart Association’s Get With The Guidelines—Heart Failure (GWTG-HF) risk score in a rural heart failure (HF) population.Background IMRS predicts mortality in general pop...
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BMJ Publishing Group
2021-12-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/8/2/e001722.full |
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| _version_ | 1846170548116127744 |
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| author | Benjamin D Horne Catherine P Benziger Erik K Engelsgjerd |
| author_facet | Benjamin D Horne Catherine P Benziger Erik K Engelsgjerd |
| author_sort | Benjamin D Horne |
| collection | DOAJ |
| description | Objective The Intermountain Risk Score (IMRS) was evaluated for validation as a mortality predictor and compared with the American Heart Association’s Get With The Guidelines—Heart Failure (GWTG-HF) risk score in a rural heart failure (HF) population.Background IMRS predicts mortality in general populations using common, inexpensive laboratory tests, patient age and sex, but requires validation in patients with HF.Methods Individuals were selected from the GWTG-HF registry at Essentia Health. This included consecutive HF inpatients age ≥18 years admitted July 2017–June 2019. IMRS was calculated using sex-specific weightings of the complete blood count, basic metabolic profile, and age.Results A total of 703 individuals (mean age: 74.12, 44.38% female) were studied. The 30-day IMRS predicted 30-day mortality for both sexes (females n=312: OR=1.19 (95% CI 1.08 to 1.32) per +1, p<0.001; males n=391: OR=1.23 (CI 1.12 to 1.36) per +1, p<0.001). The GWTG-HF risk score (only available in n=300, 42.7%) was independent of IMRS for 30-day mortality (OR=1.11 (CI 1.06 to 1.16) per +1, p<0.001). Using thresholds in bivariate modelling, IMRS (high vs low risk, OR=8.25 (CI 2.19 to 31.09), p=0.002) and the GWTG-HF score (tertile 3 vs 1: OR=2.18 (CI 0.84 to 5.68), p=0.11) independently predicted mortality. In multivariable analyses including covariables, IMRS (high vs low risk: OR=6.69 (CI 1.75 to 25.60), p=0.005) and the GWTG-HF score (tertile 3 vs 1: OR=2.62 (CI 0.96 to 7.12), p=0.06) remained predictors of mortality. Results were similar for 1-year mortality.Conclusions The IMRS and GWTG-HF scores predicted mortality of patients with HF in a large rural healthcare system. Future study of these scores as initial clinical risk estimators for evaluating their utility in improving patient health outcomes and increasing cost effectiveness is warranted. |
| format | Article |
| id | doaj-art-b6f3cd0b613e4e2fb1bdb3d911fd9bfb |
| institution | Kabale University |
| issn | 2053-3624 |
| language | English |
| publishDate | 2021-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj-art-b6f3cd0b613e4e2fb1bdb3d911fd9bfb2024-11-11T20:25:11ZengBMJ Publishing GroupOpen Heart2053-36242021-12-018210.1136/openhrt-2021-001722Validation of the Intermountain Risk Score and Get with the Guidelines—Heart Failure Score in predicting mortalityBenjamin D Horne0Catherine P Benziger1Erik K Engelsgjerd21 Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, Utah, USA2 Heart and Vascular Center, Essentia Health, Duluth, Minnesota, USADepartment of Medicine, Des Moines University, Des Moines, Iowa, USAObjective The Intermountain Risk Score (IMRS) was evaluated for validation as a mortality predictor and compared with the American Heart Association’s Get With The Guidelines—Heart Failure (GWTG-HF) risk score in a rural heart failure (HF) population.Background IMRS predicts mortality in general populations using common, inexpensive laboratory tests, patient age and sex, but requires validation in patients with HF.Methods Individuals were selected from the GWTG-HF registry at Essentia Health. This included consecutive HF inpatients age ≥18 years admitted July 2017–June 2019. IMRS was calculated using sex-specific weightings of the complete blood count, basic metabolic profile, and age.Results A total of 703 individuals (mean age: 74.12, 44.38% female) were studied. The 30-day IMRS predicted 30-day mortality for both sexes (females n=312: OR=1.19 (95% CI 1.08 to 1.32) per +1, p<0.001; males n=391: OR=1.23 (CI 1.12 to 1.36) per +1, p<0.001). The GWTG-HF risk score (only available in n=300, 42.7%) was independent of IMRS for 30-day mortality (OR=1.11 (CI 1.06 to 1.16) per +1, p<0.001). Using thresholds in bivariate modelling, IMRS (high vs low risk, OR=8.25 (CI 2.19 to 31.09), p=0.002) and the GWTG-HF score (tertile 3 vs 1: OR=2.18 (CI 0.84 to 5.68), p=0.11) independently predicted mortality. In multivariable analyses including covariables, IMRS (high vs low risk: OR=6.69 (CI 1.75 to 25.60), p=0.005) and the GWTG-HF score (tertile 3 vs 1: OR=2.62 (CI 0.96 to 7.12), p=0.06) remained predictors of mortality. Results were similar for 1-year mortality.Conclusions The IMRS and GWTG-HF scores predicted mortality of patients with HF in a large rural healthcare system. Future study of these scores as initial clinical risk estimators for evaluating their utility in improving patient health outcomes and increasing cost effectiveness is warranted.https://openheart.bmj.com/content/8/2/e001722.full |
| spellingShingle | Benjamin D Horne Catherine P Benziger Erik K Engelsgjerd Validation of the Intermountain Risk Score and Get with the Guidelines—Heart Failure Score in predicting mortality Open Heart |
| title | Validation of the Intermountain Risk Score and Get with the Guidelines—Heart Failure Score in predicting mortality |
| title_full | Validation of the Intermountain Risk Score and Get with the Guidelines—Heart Failure Score in predicting mortality |
| title_fullStr | Validation of the Intermountain Risk Score and Get with the Guidelines—Heart Failure Score in predicting mortality |
| title_full_unstemmed | Validation of the Intermountain Risk Score and Get with the Guidelines—Heart Failure Score in predicting mortality |
| title_short | Validation of the Intermountain Risk Score and Get with the Guidelines—Heart Failure Score in predicting mortality |
| title_sort | validation of the intermountain risk score and get with the guidelines heart failure score in predicting mortality |
| url | https://openheart.bmj.com/content/8/2/e001722.full |
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