A0567 The Severity Index Research of Long-term Prognosis in patients with Chronic Heart Failure

Abstract

Objectives: The study describes the derivation and validation of the Chronic HF Severity Index (CHFSI). Methods: Derivation of the CHFSI used data from single-center prospective cohort study (1998–2014) enrolling 756 patients. Logistic regression was used to identify independent predictors of mortality and quality of life over 15 years follow-up. The score was validated in the first 5-year (n = 644); in the second 5-year (n = 364) and in the third 5-year (n = 262). Results: Independent predictors of mortality were older age (OR 2.04, p < 0.001), dilated cardiomyopathy (OR 2.61, p < 0.001), faster heart rate (OR 1.46, p = 0.027), higher systolic blood pressure (OR 2.35, p < 0.001) and left ventricular ejective fraction ≦45% (OR 1.97, p = 0.018). The derived CHFSI predicted mortality: the AUC for logistic model was 0.82 (95% confidence interval, 0.78–0.85, p < 0.001). Based on the logistic model, we derived a integer scoring system, patients were classified into low risk (0–7 points), intermediate risk (8–11 points) and high risk groups (≧12 points), and the cumulative mortality for 15 years was 45.5% (125/275), 84.0% (204/243) and 100% (99/99), respectively (p < 0.001). There was a clear difference in quality of life using the 6-min walk test between patients classified as low, medium and high risk (p all < 0.0001). Conclusion: The CHFSI is a very useful clinical predictive tool that identifies patients at risk of future mortality and quality of life in the across healthcare systems.