The Singapore Heart Failure Risk Score: Prediction of Survival in Southeast Asian Patients.

Authors:
Jonathan Yap
Jonathan Yap
Tan Tock Seng Hospital
Singapore
Shaw Yang Chia
Shaw Yang Chia
Department of Cardiology
Fang Yi Lim
Fang Yi Lim
Yong Loo Lin School of Medicine
John C Allen
John C Allen
Duke-NUS Graduate Medical School
Singapore
David Sim
David Sim
Cardiovascular Research Institute
Singapore
Fazlur Rehman Jaufeerally
Fazlur Rehman Jaufeerally
Singapore General Hospital
Singapore

Ann Acad Med Singapore 2019 Mar;48(3):86-94

Department of Cardiology, National Heart Centre, Singapore.

Introduction: Numerous heart failure risk scores have been developed but there is none for Asians. We aimed to develop a risk calculator, the Singapore Heart Failure Risk Score, to predict 1- and 2-year survival in Southeast Asian patients hospitalised for heart failure.

Materials And Methods: Consecutive patients admitted for heart failure were identified from the Singapore Cardiac Databank Heart Failure registry. The follow-up was 2 to 4 years and mortality was obtained from national registries.

Results: The derivation (2008-2009) and 2 validation cohorts (2008-2009, 2013) included 1392, 729 and 804 patients, respectively. Ten variables were ultimately included in the risk model: age, prior myocardial infarction, prior stroke, atrial fibrillation, peripheral vascular disease, systolic blood pressure, QRS duration, ejection fraction and creatinine and sodium levels. In the derivation cohort, predicted 1- and 2-year survival was 79.1% and 68.1% compared to actual 1- and 2-year survival of 78.2% and 67.9%. There was good agreement between the predicted and observed mortality rates (Hosmer-Lemeshow statistic = 14.36, = 0.073). C-statistics for 2-year mortality in the derivation and validation cohorts were 0.73 (95% CI, 0.70-0.75) and 0.68 (95% CI, 0.64-0.72), respectively.

Conclusion: We provided a risk score based on readily available clinical characteristics to predict 1- and 2-year survival in Southeast Asian patients hospitalised for heart failure via a simple online risk calculator, the Singapore Heart Failure Risk Score.

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March 2019
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