RT Journal Article
T1 The EPICTER score: a bedside and easy tool to predict mortality at 6 months in acute heart failure
A1 Romero-Correa, Miriam
A1 Salamanca-Bautista, Prado
A1 Bilbao-Gonzalez, Amaia
A1 Quiros-Lopez, Raul
A1 Dolores Nieto-Martin, Maria
A1 Luisa Martin-Jimenez, Maria
A1 Luis Morales-Rull, Jose
A1 Quiles-Garcia, Dolores
A1 Gomez-Gigirey, Adriana
A1 Formiga, Francesc
A1 Aramburu-Bodas, Oscar
A1 Luis Arias-Jimenez, Jose
A1 EPICTER Investigators Grp, 
K1 Advanced heart failure
K1 Palliative care
K1 Risk score
K1 Prognosis
K1 Palliative care
K1 Risk stratification
K1 Surprise question
K1 Task-force
K1 Validation
K1 Models
K1 Hospitalization
K1 Classification
K1 Association
K1 Derivation
AB 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.
PB Wiley periodicals, inc
SN 2055-5822
YR 2022
FD 2022-04-12
LK http://hdl.handle.net/10668/21895
UL http://hdl.handle.net/10668/21895
LA en
DS RISalud
RD Apr 11, 2025