The COACH risk engine : A multistate model for predicting survival and hospitalization in patients with heart failure
Journal article
Postmus, Douwe, van Veldhuisen, Dirk, Jaarsma, Trijntje, Luttik, Marie-Louise, Lassus, Johan, Mebazaa, Alexandre, Nieminen, Markku, Harjola, Veli-Pekka, Lewsey, James, Buskens, Erik and Hillege, Hans. (2012). The COACH risk engine : A multistate model for predicting survival and hospitalization in patients with heart failure. European Journal of Heart Failure. 14(2), pp. 168 - 175. https://doi.org/10.1093/eurjhf/hfr163
Authors | Postmus, Douwe, van Veldhuisen, Dirk, Jaarsma, Trijntje, Luttik, Marie-Louise, Lassus, Johan, Mebazaa, Alexandre, Nieminen, Markku, Harjola, Veli-Pekka, Lewsey, James, Buskens, Erik and Hillege, Hans |
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Abstract | Aims: Several models for predicting the prognosis of heart failure (HF) patients have been developed, but all of them focus on a single outcome variable, such as all-cause mortality. The purpose of this study was to develop a multistate model for simultaneously predicting survival and HF-related hospitalization in patients discharged alive from hospital after recovery from acute HF. Methods and results: The model was derived in the COACH (Coordinating Study Evaluating Outcomes of Advising and Counseling in Heart Failure) cohort, a multicentre, randomized controlled trial in which 1023 patients were enrolled after hospitalization because of HF. External validation was attained with the FINN-AKVA (Finish Acute Heart Failure Study) cohort, a prospective, multicentre study with 620 patients hospitalized due to acute HF. The observed vs. predicted 18-month survival was 72.1% vs. 72.3% in the derivation cohort and 71.4% vs. 71.2% in the validation cohort. The corresponding values of the c statistic were 0.733 [95% confidence interval (CI) 0.705–0.761] and 0.702 (95% CI 0.663–0.744), respectively. The model's accuracy in predicting HF hospitalization was excellent, with predicted values that closely resembled the values observed in the derivation cohort. Conclusion: The COACH risk engine accurately predicted survival and various measures of recurrent hospitalization in (acute) HF patients. It may therefore become a valuable tool in improving and personalizing patient care and optimizing the use of scarce healthcare resources. |
Year | 2012 |
Journal | European Journal of Heart Failure |
Journal citation | 14 (2), pp. 168 - 175 |
ISSN | 1388-9842 |
Digital Object Identifier (DOI) | https://doi.org/10.1093/eurjhf/hfr163 |
Page range | 168 - 175 |
Research Group | Mary MacKillop Institute for Health Research |
Publisher's version | File Access Level Controlled |
https://acuresearchbank.acu.edu.au/item/895z1/the-coach-risk-engine-a-multistate-model-for-predicting-survival-and-hospitalization-in-patients-with-heart-failure
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