Methods:We applied the SENIORS riskmodel to 926 patients in RICA to estimate risk at one year of a) composite outcome of all-cause mortality or cardiovascular hospital admission and b) all-cause mortality.
Results: In the RICA registrymean age was 78 years, mean ejection fraction 51% and 87% were in NYHA II and III. At one year death/CV hospitalization occurred in 31.9% and all-causemortality in 19.5%. The riskmodel provided good separation of Kaplan Meier curves stratified by tertile for death/CV hospitalization and all-cause mortality.
The observed versus expected rates of death/CV hospitalization in the lowest, middle and highest risk tertiles were (%) 34/24, 45/41 and 57/67, and for death 13/16, 32/38 and 44/70 respectively. C-statistic for all-causemortality
or CV hospitalization was 0.60 and for all-cause mortality 0.66.
Conclusion: The SENIORS risk model was a reliable tool for relative risk stratification among acute heart failure patients in a “real world” registry, but predicted versus observed risk showed some variability. The model provides
a useful basis for clinical risk prediction.