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使用患者报告的健康状况预测心力衰竭结果:KCCQ-12的现实世界验证

Bassim R El-Sabawi¹, Mohammed A Al-Garadi², Bryan D Steitz²

¹Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Journal of the American College of Cardiology

|June 11, 2025

概括

堪萨斯城心肌病问卷-12 (KCCQ-12) 有效预测心力衰竭住院和门诊病例中的死亡率. 较低的KCCQ-12分数和未完成表明更高的风险,验证其作为预后工具的使用.

科学领域:

心脏病学心脏病学
临床结果研究研究
医疗保健服务研究医疗服务研究

背景情况:

堪萨斯城心肌病问卷-12 (KCCQ-12) 是患者报告的心力衰竭的结果指标.
它在现实世界临床实践中对住院和死亡率的预测实用性并不成熟,与临床试验不同.

研究的目的:

评估KCCQ-12对接受门诊心力衰竭护理的患者住院和死亡率的预测价值.
评估KCCQ-12总体总结 (KCCQ-OS) 评分作为预后指标的表现.

主要方法:

一项队列研究,涉及从2019年7月到2024年3月的心力衰竭诊所的4,406名患者.
主要暴露:KCCQ-OS得分.主要暴露:KCCQ-OS得分. 主要结局:住院90天和累积死亡率.
统计分析包括后勤回归,Cox比例危险模型和机器学习 (XGBoost,随机生存森林).

主要成果:

在完成KCCQ-12的2888名 (66%) 患者中,观察到KCCQ-OS的中位数为59.4.
评分<25与90天住院 (OR:3.49) 和累积死亡率 (HR:3.09) 的调整后风险显著增加有关.
对于这两种结果,KCCQ-OS是机器学习模型中最重要的预测因素. 不完成也预测了更糟糕的结果.

结论:

在门诊心力衰竭护理中,较低的KCCQ-OS得分与住院治疗和死亡率的增加密切相关.
包括其未完成状态在内的KCCQ-12在常规临床实践中作为一种有价值的预后工具.
在关键不良事件的机器学习分析中,KCCQ-OS得分显示出占主导地位的预测能力.

关键词:

医疗信息学医疗信息学心脏衰竭是因为心脏衰竭.机器学习是机器学习.患者报告的结果.预后预后预后

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