Description

Betihavas et al developed a model and nomogram for predicting unplanned readmission for a patient with congestive heart failure. This can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Sydney, University of Western Sydney, University of New South Wales, University of Technology, Baker IDI Heart and Diabetes Institute and Johns Hopkins University.


Patient selection: congestive heart failure from 25 to 95 years of age

 

Outcome: unplanned readmission for heart failure

 

Parameters used for nomogram

(1) age in years

(2) sex

(3) living alone

(4) sedentary lifestyle

(5) Charlson Comorbidity Index

(6) years with heart failure

 

points for age =

= (0.28571 * (age)) - 7.1428571

 

Parameter

Finding

Points

sex

male

0

 

female

1.45

lives alone

no

0

 

yes

1.87

sedentary lifestyle

no

0

 

yes

7.47

Charlson Comorbidity

0 or 1

0

 

2 to 4

6.75

 

>= 5

11.33

years with CHF

< 10

0

 

>= 10

2.41

 

total score =

= SUM(points for all parameters)

 

Interepretation:

• minimum score: 0

• maximum score: 44.5

 

Score

28-day readmission rate

< 19

< 5%

19 to 38.8

(0.0002472 * ((score)^2)) - (0.0067056 * (score)) + 0.088288

> 38.8

> 20%

 

 

Score

1-year readmission rate

< 8.7

< 15%

8.7 to 44.2

(-0.000012862 * ((score)^3)) + (0.0012281 * ((score)^2)) - (0.012819 * (score)) + 0.18188

> 44.2

> 90%

 

Performance:

• The area under the ROC curve was 0.80.


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