A UCLA team has developed an easy-to-use "risk calculator" that helps predict heart failure patients' chances of survival for up to five years and assists doctors in determining whether more or less aggressive treatment is appropriate.
Given that heart failure impacts more than 5 million Americans and numerous variables affect patient outcomes, this type of risk-assessment tool can be very helpful to physicians and patients in assessing prognosis over time and guiding medical decision-making, the researchers say.
Their new risk model is featured in the January edition of the journal Circulation: Heart Failure.
Since heart failure manifests differently in men and women, the team initially sought to create a sex-specific risk model for greater accuracy, an approach that hadn't been taken before. But they discovered that separate risk models for men and women weren't necessary.
"We were extremely surprised that the same exact top predictors of risk were identical in both men and women," said senior author Dr. Tamara Horwich, an assistant professor of medicine in the cardiology division at the David Geffen School of Medicine at UCLA. "We ultimately only needed to create one unified heart failure risk model for both sexes."
Heart failure occurs when the heart can no longer pump enough blood to the body's other organs. Often, patients with heart failure have reduced left-ventricle ejection fraction, which indicates a lowered volume of blood being pumped out of this heart chamber with each beat of the heart.
In developing the risk calculator, the UCLA team used data from 2,255 heart failure patients, including 1,569 men and 686 women, who were referred to the Ahmanson-UCLA Cardiomyopathy Center between 2000 and 2011.
They collected 39 patient variables, including information like age, weight, medications, lab work and the results of diagnostic tests such as echocardiography - the use of ultrasound to investigate the action of the heart.
The team assessed each variable in terms of predicting the following serious risks: mortality, the need for an urgent transplant, and the need for a mechanical pump known as a ventricular assist device. Using a complex statistical analysis, they determined that four of the 39 factors were predictive of these serious risks in both men and women and could predict survival over a five-year period.
The four variables included: