Validation of U.S. mortality prediction models for hospitalized heart failure in the United Kingdom and Japan

European Journal of Heart Failure
Toshiyuki NagaiJohn G F Cleland

Abstract

Prognostic models for hospitalized heart failure (HHF) were developed predominantly for patients of European origin in the United States of America; it is unclear whether they perform similarly in other health care systems or for different ethnicities. We sought to validate published prediction models for HHF in the United Kingdom (UK) and Japan. Patients in the UK (n =894) and Japan (n =3158) were prospectively enrolled and were similar in terms of sex (∼60% men) and median age (∼77 years). Models predicted that British patients would have a higher mortality than Japanese, which was indeed true both for in-hospital (4.8% vs. 2.5%) and 180-day (20.7% vs. 9.5%) mortality. The model c-statistics for the published/derivation (range 0.70-0.76) and Japanese (range 0.75-0.77) cohorts were similar and higher than for the UK (0.62-0.75) but models consistently overestimated mortality in Japan. For in-hospital mortality, the OPTIMIZE-HF model performed best, providing similar discrimination in published/derivation, UK and Japanese cohorts [c-indices: 0.75 (0.74-0.77); 0.75 (0.68-0.81); and 0.77 (0.70-0.83), respectively], and least overestimated mortality in Japan. For 180-day mortality, the c-statistics for the ASCEND-HF model were sim...Continue Reading

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Citations

Feb 20, 2019·European Heart Journal·John G F ClelandPiotr Ponikowski
Mar 19, 2019·European Journal of Heart Failure·Marco Metra
May 10, 2019·European Journal of Heart Failure·Marco Metra
May 8, 2019·Circulation Journal : Official Journal of the Japanese Circulation Society·Toshiyuki Nagai, Toshihisa Anzai
Jan 31, 2020·ESC Heart Failure·Daniela TomasoniMarco Metra
Dec 6, 2020·ESC Heart Failure·Daniela TomasoniMarco Metra
Mar 5, 2021·Circulation Journal : Official Journal of the Japanese Circulation Society·Toshiyuki NagaiToshihisa Anzai
Jul 4, 2020·JACC. Heart Failure·John G F ClelandYola Jones

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