A simple validated method for predicting the risk of hospitalization for worsening of heart failure in ambulatory patients: the Redin‐SCORE

Aims Prevention of hospital readmissions is one of the main objectives in the management of patients with heart failure ( HF ). Most of the models predicting readmissions are based on data extracted from hospitalized patients rather than from outpatients. Our objective was to develop a validated score predicting 1‐month and 1‐year risk of readmission for worsening of HF in ambulatory patients. Methods and results A cohort of 2507 ambulatory patients with chronic HF was prospectively followed for a median of 3.3 years. Clinical, echocardiographic, ECG , and biochemical variables were used in a competing risk regression analysis to construct a risk score for readmissions due to worsening of HF . Thereafter, the score was externally validated using a different cohort of 992 patients with chronic HF ( MUSIC registry). Predictors of 1‐month readmission were the presence of elevated natriuretic peptides, left ventricular (LV) HF signs, and estimated glomerular filtration rate ( eGFR ) <60 mL /min/m 2 . Predictors of 1‐year readmission were elevated natriuretic peptides, anaemia, left atrial size >26 mm/m 2 , heart rate >70 b.p.m., LV HF signs, and eGFR <60 mL /min/m 2 . The C‐statistics for the models were 0.72 and 0.66, respectively. The cumulative incidence function distinguished low‐risk (<1% event rate) and high‐risk groups (>5% event rate) for 1‐month HF readmission. Likewise, low‐risk (7.8%), intermediate‐risk (15.6%) and high‐risk groups (26.1%) were identified for 1‐year HF readmission risk. The C‐statistics remained consistent after the external validation (<5% loss of discrimination). Conclusion The Redin‐ SCORE predicts early and late readmission for worsening of HF using proven prognostic variables that are routinely collected in outpatient management of chronic HF .