%0 Journal Article
%A Romero-Correa, Miriam
%A Salamanca-Bautista, Prado
%A Bilbao-Gonzalez, Amaia
%A Quiros-Lopez, Raul
%A Dolores Nieto-Martin, Maria
%A Luisa Martin-Jimenez, Maria
%A Luis Morales-Rull, Jose
%A Quiles-Garcia, Dolores
%A Gomez-Gigirey, Adriana
%A Formiga, Francesc
%A Aramburu-Bodas, Oscar
%A Luis Arias-Jimenez, Jose
%A EPICTER Investigators Grp
%T The EPICTER score: a bedside and easy tool to predict mortality at 6 months in acute heart failure
%D 2022
%@ 2055-5822
%U http://hdl.handle.net/10668/21895
%X Aims Estimating the prognosis in heart failure (HF) is important to decide when to refer to palliative care (PC). Our objective was to develop a tool to identify the probability of death within 6 months in patients admitted with acute HF.Methods and results A total of 2848 patients admitted with HF in 74 Spanish hospitals were prospectively included and followed for 6 months. Each factor independently associated with death in the derivation cohort (60% of the sample) was assigned a prognostic weight, and a risk score was calculated. The accuracy of the score was verified in the validation cohort. The characteristics of the population were as follows: advanced age (mean 78 years), equal representation of men and women, significant comorbidity, and predominance of HF with preserved ejection fraction. During follow-up, 753 patients (26%) died. Seven independent predictors of mortality were identified: age, chronic obstructive pulmonary disease, cognitive impairment, New York Heart Association class III-IV, chronic kidney disease, estimated survival of the patient less than 6 months, and acceptance of a palliative approach by the family or the patient. The area under the ROC curve for 6 month death was 0.74 for the derivation and 0.68 for the validation cohort. The model showed good calibration (Hosmer and Lemeshow test, P value 0.11). The 6 month death rates in the score groups ranged from 6% (low risk) to 54% (very high risk).Conclusions The EPICTER score, developed from a prospective and unselected cohort, is a bedside and easy-to-use tool that could help to identify high-risk patients requiring PC.
%K Advanced heart failure
%K Palliative care
%K Risk score
%K Prognosis
%K Palliative care
%K Risk stratification
%K Surprise question
%K Task-force
%K Validation
%K Models
%K Hospitalization
%K Classification
%K Association
%K Derivation
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