Table 1.
Baseline characteristics at admission.
Table 2.
Initial risk assessment and patients’ data during hospitalization.
Table 3.
Logistic regression analysis on in-hospital mortality in derivation cohort.
Table 4.
Time course risk scores.
Fig 1.
Case examples for time course risk scoring.
(A) An 83-year-old male with ischemic heart disease was admitted for the exacerbation of heart failure. His Get With the Guidelines—Heart Failure (GWTG—HF) risk score, with the exception of a racial score, was 45 points at admission, which implied a 1 to 5% estimation of in-hospital mortality according to the original report [7]. In a sequential risk assessment over hospitalization, a maximal value of the time course risk score was 10 points on day one. Thus, the maximal value of the total score over the patient’s hospital stay was 55, which suggested 1 to 5% of in-hospital mortality according to our study. The patient’s condition improved rapidly and he was discharged on day nine. (B) A 79-year-old male with heart failure and a preserved ejection fraction had a GWTG—HF risk score, with the exception of a racial score, of 47 points at admission, which also implied a 1 to 5% estimation of in-hospital mortality. His time course risk score was also 10 points on day one; however, with his disease condition worsening, his time course risk score gradually increased to a maximal value of 50 points at day five, which implied an over 70% estimation of in-hospital mortality. He did not show any improvement in his condition and finally died on day nine. BUN: blood urea nitrogen; COPD: chronic obstructive pulmonary disease; CRP: C-reactive protein; HR: heart rate; SBP: systolic blood pressure.
Fig 2.
Discrimination and calibration of the novel risk model.
(A) Receiver operating characteristic curves for the GWTG—HF risk score (broken line) and total in-hospital risk score (solid line) in derivation and validation cohorts. (B) Calibration plots of observed to predicted mortalities according to deciles in derivation and validation cohorts.
Fig 3.
Risk distribution in the overall cohort.
(A) Subdivision, in the overall cohort, of the GWTG—HF risk score by three classes of time course risk scores. (B) Risk chart of the total in-hospital risk score model.