Philbin and DiSalvo developed a risk score for predicting readmission for a patient hospitalized with heart failure. This can help identify patients who may benefit from more aggressive management. The authors are from Henry Ford Hospital (Detroit) and Massachusetts General Hospital.
Parameters:
(1) race
(2) health coverage
(3) health services on discharge
(4) ischemic heart disease
(5) valvular heart disease
(6) diabetes mellitus
(7) renal disease
(8) chronic lung disease
(9) idiopathic cardiomyopathy
(10) history of cardiac surgery
(11) use of telemetry during the index hospitalization
(12) treatment hospital
(13) echocardiogram performed during the index hospitalization
(14) cardiac catheterization performed during the index hospitalization
|
Parameter |
Finding |
Points |
|---|---|---|
|
race |
Black |
1 |
|
|
other |
0 |
|
health coverage |
Medicare |
1 |
|
|
Medicaid |
1 |
|
|
other |
0 |
|
health services on discharge |
none |
0 |
|
|
home health care services |
1 |
|
|
skilled nursing facility |
(-1) |
|
ischemic heart disease |
absent |
0 |
|
|
present |
1 |
|
valvular heart disease |
absent |
0 |
|
|
present |
1 |
|
diabetes mellitus |
absent |
0 |
|
|
present |
1 |
|
renal disease |
absent |
0 |
|
|
present |
1 |
|
chronic lung disease |
absent |
0 |
|
|
present |
1 |
|
idiopathic cardiomyopathy |
absent |
0 |
|
|
present |
1 |
|
history of cardiac surgery |
absent |
0 |
|
|
present |
1 |
|
use of telemetry |
absent |
0 |
|
|
present |
1 |
|
treatment hospital |
urban |
0 |
|
|
rural |
(-1) |
|
echocardiography |
not performed |
0 |
|
|
performed |
(-1) |
|
cardiac catheterization |
not performed |
0 |
|
|
performed |
(-1) |
where:
• A rural hospital is any not urban. An urban hospital is one located in a county which is part of a Federal Metropolitan Statistical Area.
total risk score =
= SUM(points for all 14 parameters) + 4
Interpretation:
• minimum score: 0 (adding 4 prevents a negative score)
• maximum score: 15
• The higher the score the more likely the patient will be readmitted.
|
Total Score |
Probability of Readmission |
|---|---|
|
0 to 3 |
10% |
|
4 |
14% |
|
5 |
16% |
|
6 |
20% |
|
7 |
23% |
|
8 |
27% |
|
9 |
29% |
|
10 |
34% |
|
11 to 15 |
46% |
from Figure 1, page 1564
Performance:
• The area under the ROC curve is 0.60.
Purpose: To evaluate a patient hospitalized with heart failure for the risk of readmission after discharge using the simple risk score of Philbin and DiSalvo.
Specialty: Cardiology
Objective: risk factors, severity, prognosis, stage, complications, selection
ICD-10: I50,
