Assessment value of the modified early warning score for long-term prognosis of older patients with chronic heart failure.

IF 0.7 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Journal of Africa Pub Date : 2024-01-23 Epub Date: 2023-04-28 DOI:10.5830/CVJA-2023-003

Yin Yin, Jie Chen, Shijiu Jiang

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引用次数: 0

Abstract

Aim: The aim of the study was to explore the assessment value of the modified early warning score (MEWS) for the long-term prognosis of older patients with chronic heart failure (CHF).

Methods: A total of 180 CHF patients, treated from January 2016 to January 2018, were divided into a grade I group (n = 28), a grade II group (n = 37), a grade III group (n = 68) and a grade IV group (n = 47) according to the New York Heart Association (NYHA) functional classification. The MEWS was compared on admission and discharge. Based on the clinical outcomes during follow up, the patients were divided into a non-survival group (n = 48) and a survival group (n = 132). Their general clinical data and the MEWS were compared. The predictive values of the MEWS, troponin I (cTnI) and B-type natriuretic (BNP) peptide for long-term prognosis were assessed using receiver operator characteristic (ROC) curves.

Results: The MEWS on patient discharge was significantly lower than that on admission, and it increased with increasing NYHA grade (p < 0.05). The MEWS in the non-survival group was significantly higher than that in the survival group. Different clinical outcomes were positively correlated with NYHA grade, MEWS, six-minute walking distance and left ventricular ejection fraction (r = 0.368, r = 0.471, r = 0.387, r = 0.423, p < 0.05), and negatively correlated with cTnI and BNP (r = -0.411, r = -0.425). The area under the ROC curve of the MEWS was 0.852, indicating higher accuracy. The optimal cut-off value, sensitivity and specificity of the MEWS for determining prognosis were 5.6, 0.854 and 0.797 points, respectively.

Conclusion: The MEWS rose with increasing NYHA grade and reflected the severity of CHF in older patients, which has higher predictive value for long-term prognosis.

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改良预警评分对老年慢性心力衰竭患者长期预后的评估价值。

目的：该研究旨在探讨改良早期预警评分（MEWS）对老年慢性心力衰竭（CHF）患者长期预后的评估价值：根据纽约心脏病学会（NYHA）的功能分级，将2016年1月至2018年1月接受治疗的180名CHF患者分为I级组（28人）、II级组（37人）、III级组（68人）和IV级组（47人）。对入院和出院时的 MEWS 进行了比较。根据随访期间的临床结果，患者被分为非存活组（48 人）和存活组（132 人）。对他们的一般临床数据和 MEWS 进行了比较。使用接收器操作特征曲线（ROC）评估了MEWS、肌钙蛋白I（cTnI）和B型钠尿肽（BNP）对长期预后的预测价值：患者出院时的 MEWS 明显低于入院时的 MEWS，且随着 NYHA 分级的升高而升高（P < 0.05）。非存活组的 MEWS 明显高于存活组。不同的临床结果与NYHA分级、MEWS、6分钟步行距离和左室射血分数呈正相关（r = 0.368、r = 0.471、r = 0.387、r = 0.423，p < 0.05），与cTnI和BNP呈负相关（r = -0.411、r = -0.425）。MEWS 的 ROC 曲线下面积为 0.852，表明其准确性更高。MEWS判断预后的最佳临界值、灵敏度和特异性分别为5.6、0.854和0.797点：结论：MEWS随NYHA分级的升高而升高，反映了老年患者CHF的严重程度，对长期预后有较高的预测价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiovascular Journal of Africa CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： The Cardiovascular Journal of Africa (CVJA) is an international peer-reviewed journal that keeps cardiologists up to date with advances in the diagnosis and treatment of cardiovascular disease. Topics covered include coronary disease, electrophysiology, valve disease, imaging techniques, congenital heart disease (fetal, paediatric and adult), heart failure, surgery, and basic science.