Prevalence of advanced heart failure and use of palliative care in admitted patients: Findings from the EPICTER study

Fernández‐Martínez, J.; Romero-Correa, Miriam; Salamanca‐Bautista, Prado; Aramburu‐Bodas, Óscar; Formiga, Francesç; Vázquez-Rodríguez, Patricia; Conde‐Martel, Alicia; García‐García, José A.; Paez-Rubio, Inmaculada; López‐Reboiro, Manuel Lorenzo; Sánchez-Sánchez, C.; Arias‐Jiménez, José Luis

doi:10.1016/j.ijcard.2020.11.002

Cited by 18 publications

(14 citation statements)

References 42 publications

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“…The EPICTER score assessed the mid‐term mortality (both in‐hospital and early death after discharge) of acute HF patients who could benefit from inclusion in a PC programme, an environment where little information is available. We did not exclude patients who died during index admission because the shortage of comprehensive PC is evident in studies describing the end of life of HF patients, including those hospitalized 13,21 . Moreover, 60–80% of deaths in patients with HF occur in the hospital setting, 22 and a risk score for dying within 6 months of an admission for HF could facilitate clinicians to improve care planning and decision‐making, even in patients in their last days of life who die within admission.…”

Section: Discussionmentioning

confidence: 99%

“…The EPICTER study (“epidemiological survey of advanced heart failure”) was a multicentre, prospective, nationwide in Spain project that consecutively collected patients admitted for acute HF in 74 Spanish hospitals. The EPICTER study has been previously described 13 . All patients admitted for HF in any department (Cardiology, Internal Medicine, Intensive Care, PC, and others) of the participating hospitals were collected in two periods.…”

Section: Methodsmentioning

confidence: 99%

“…The EPICTER study has been previously described. 13 All patients admitted for HF in any department (Cardiology, Internal Medicine, Intensive Care, PC, and others) of the participating hospitals were collected in two periods. In brief, researchers began collecting data on the same day (1 June and 30 November 2016) and continued to recruit patients on subsequent days until the required number was completed.…”

Section: Methodsmentioning

confidence: 99%

“…Each factor was assigned a prognostic weight based on each β parameter and the risk score was calculated (score range 0-25 points). Patients were grouped into death-risk groups: low (0-3 points), medium (4-9 points), high (10)(11)(12)(13)(14)(15)(16), and very high (17)(18)(19)(20)(21)(22)(23)(24)(25). The 6 month death rates in the score groups were as follows: low risk 5.7%, medium risk 17.8%, high risk 35.1%, and very high risk 53.8%.…”

Section: Predictors Of Mortality and Risk Scorementioning

confidence: 99%

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The EPICTER score: a bedside and easy tool to predict mortality at 6 months in acute heart failure

et al. 2022

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Aims Estimating the prognosis in heart failure (HF) is important to decide when to refer to palliative care (PC). Our objective was to develop a tool to identify the probability of death within 6 months in patients admitted with acute HF. Methods and results A total of 2848 patients admitted with HF in 74 Spanish hospitals were prospectively included and followed for 6 months. Each factor independently associated with death in the derivation cohort (60% of the sample) was assigned a prognostic weight, and a risk score was calculated. The accuracy of the score was verified in the validation cohort. The characteristics of the population were as follows: advanced age (mean 78 years), equal representation of men and women, significant comorbidity, and predominance of HF with preserved ejection fraction. During follow-up, 753 patients (26%) died. Seven independent predictors of mortality were identified: age, chronic obstructive pulmonary disease, cognitive impairment, New York Heart Association class III-IV, chronic kidney disease, estimated survival of the patient less than 6 months, and acceptance of a palliative approach by the family or the patient. The area under the ROC curve for 6 month death was 0.74 for the derivation and 0.68 for the validation cohort. The model showed good calibration (Hosmer and Lemeshow test, P value 0.11). The 6 month death rates in the score groups ranged from 6% (low risk) to 54% (very high risk). Conclusions The EPICTER score, developed from a prospective and unselected cohort, is a bedside and easy-to-use tool that could help to identify high-risk patients requiring PC.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Predictors Of Mortality and Risk Scorementioning

confidence: 99%

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The EPICTER score: a bedside and easy tool to predict mortality at 6 months in acute heart failure

et al. 2022

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“…It is of interest the approach of patients with advanced HF. A previous study of this working group showed a high prevalence of advanced disease and a low use of palliative care along with new criteria for defining it 23 . In this new registry, we will prove its validity in that new population.…”

Section: Assessment Of Congestion and Strategies To Achieve Decongestionmentioning

confidence: 99%

Epidemiology, clinical and prognostic factors in Spanish patients with heart failure: The RICA-2 registry

Arévalo‐Lorido¹,

Aramburu²,

Casado³

et al. 2022

SJMED

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Introduction: Heart failure (HF) is a syndrome of epidemic proportions and one of the main reasons for hospitalization worldwide. Different scientific societies have risen interest in the creation of their own registries to study the characteristics and prognosis of these patients. Each registry covers a part of the spectrum of this heterogeneous syndrome and is useful to address questions that are difficult to answer in clinical trials. The RICA-2 is a national registry created by the Heart Failure Working Group of the Spanish Society of Internal Medicine and offers an Internal Medicine perspective of this pathology. Objectives: The main objective is to assess clinical and epidemiological characteristics and prognostic factors among patients with HF. Secondary objectives include: (1) To determine clinical/epidemiological/phenotypic characteristics and prognosis specifically in patients with HF and preserved left-ventricle ejection fraction (LVEF); (2) To examine how functional status, cognition, frailty, and nutrition influence the prognosis of patients with HF; (3) To assess congestion and strategies to achieve decongestion during the acute decompensation phase. Methods: A multicentre, prospective, observational cohort study including patients with HF attended in Spanish Internal Medicine Departments. Patients will be recruited in the acute decompensation phase or in the stable phase in the outpatient setting, including de novo and chronically decompensated patients. Patients will be included regardless of HF aetiology, LVEF values and comorbidities. Conclusions: Our work is a prospective study that aims to improve knowledge regarding epidemiology and prognosis in patients with HF, with focus on functionality, cognition, frailty, nutrition, and congestion phase.

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Different profiles of advanced heart failure among patients with and without diabetes mellitus. Findings from the EPICTER study

Lorido¹,

Gómez²,

Correa³

et al. 2022

European Journal of Internal Medicine

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Prevalence of advanced heart failure and use of palliative care in admitted patients: Findings from the EPICTER study

Cited by 18 publications

References 42 publications

The EPICTER score: a bedside and easy tool to predict mortality at 6 months in acute heart failure

The EPICTER score: a bedside and easy tool to predict mortality at 6 months in acute heart failure

Epidemiology, clinical and prognostic factors in Spanish patients with heart failure: The RICA-2 registry

Different profiles of advanced heart failure among patients with and without diabetes mellitus. Findings from the EPICTER study

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