Khaniukov O. O., Smolianova O. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Given that chronic heart failure (CHF) refers to ambulatory care–sensitive conditions, the hospital admission number can be reduced. One way to reduce this is to search for predictors that are easy to analyze in routine clinical practice. Aim. Identify predictors and develop a model for hospitalization prediction in the next 6 months in the elderly with CHF on the background of hypertension (AH) and chronic kidney disease (CKD) in an outpatient setting. Objects and methods. The study included 111 ambulatory patients, aged 60 to 74 years, with CHF stage II, AH stage II and CKD stage II-IIIa. To assess the predictive possibility of variables and develop a prediction model logistic analysis was used. Results. The stepwise multiple logistic regression analysis found a statistically significant connection with a probability of hospitalization for the next variables: medication adherence (р=0,028), GFR EPI EPI≤59,9 mL/min/1,73 m2 (р=0,027), the presence of crackles over the lungs (р=0,0011), NYHA functional class (р=0,033). According to the assessment results of the obtained model χ2 = 43,78, df=4, р<0,0001, AUC – 0,91 (CI 0,83-0,96), р<0,0001. According to the obtained Somers’ D value, the predictive possibility of our model was 82%. The optimal cut-off threshold for the model was found to be >0,155 (J – 0,696, sensitivity – 90,48%, specificity – 79,17%). Conclusions. According to the results of multiple logistic analysis, medication adherence, GFR EPI ≤59.9 ml/ min/1.73 m2, the presence of crackles over the lungs, as well as NYHA FC are statistically significant predictors of hospitalization for CHF in elderly patients. These indicators are simple for routine assessment and should be modified in an outpatient setting to reduce hospitalization in the elderly with CHF.

chronic heart failure, hospitalization, prognostic model, ambulatory care–sensitive conditions, chronic kidney disease.

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«Bulletin of problems biology and medicine» Issue 3 (161), 2021 year, 149-153 pages, index UDK 616.12-008.46-036.1-037-07-053.9:614.21:164

10.29254/2077-4214-2021-3-161-149-153