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CARDIOVASCULAR MEDICINE

Predicting mortality in patients with heart failure:
a pragmatic approach
M L Bouvy, E R Heerdink, H G M Leufkens, A W Hoes

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Correspondence to:
Dr Marcel L Bouvy,
Department of
Pharmacoepidemiology
and Pharmacotherapy,
Utrecht Institute for
Pharmaceutical Sciences
(UIPS), PO Box 80082,
3508 TB Utrecht,
Netherlands;
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Objective: To develop a comprehensive and easily applicable prognostic model predicting mortality
risk in patients with moderate to severe heart failure
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Setting: Seven general hospitals in the Netherlands
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Duration of follow up was at least 18 months
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The area under receiver
operating characteristic curves (AUC) was used to estimate the predictive ability of the prognostic models
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Independent predictors of mortality were diabetes mellitus, a history of renal dysfunction (or higher creatinine), New York Heart
Association (NYHA) functional class III or IV, lower weight or body mass index, lower blood pressure,
ankle oedema, and higher scores on a disease specific quality of life questionnaire
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These factors were used to derive various prediction formulas
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M

ortality among patients with heart failure discharged
from hospital has repeatedly been reported to be
high
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A wide variety of factors is reported to be associated
with an increased risk of hospital admission or death, including
demographic factors (for example, male sex and single marital
status), clinical characteristics (lower systolic blood pressure,
renal dysfunction), history of heart failure (previous hospital
admissions), and comorbidity (diabetes and depression)
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5–7
Our aim in this study was to develop a comprehensive and
easily applicable prognostic model predicting the risk of death
in patients with heart failure, based on information that is
readily available in medical practice
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7
years, range 37–91 years) enrolled in a randomised controlled
trial evaluating the effect of a pharmacist led intervention on
drug compliance in patients with heart failure

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