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Predicting mortality among patients hospitalized for heart failure: derivation and validation of a clinical model
Lee DS, Austin PC, Rouleau JL, Liu PP, Naimark D, Tu JV.. JAMA, 2003-11-01
Topic: Risk, prevention and care in population studies
Context A predictive model of mortality in heart failure may be useful for clinicians to improve communication with and care of hospitalized patients. Objectives To identify predictors of mortality and to develop and to validate a model using information available at hospital presentation. Design, setting, and participants Retrospective study of 4031 community-based patients presenting with heart failure at multiple hospitals in Ontario, Canada (2624 patients in the derivation cohort from 1999-2001 and 1407 patients in the validation cohort from 1997-1999), who had been identified as part of the Enhanced Feedback for Effective Cardiac Treatment (EFFECT) study. Main outcome measures All-cause 30-day and 1-year mortality. Results The mortality rates for the derivation cohort and validation cohort, respectively, were 8.9% and 8.2% in hospital, 10.7% and 10.4% at 30 days, and 32.9% and 30.5% at 1 year. Multivariable predictors of mortality at both 30 days and 1 year included older age, lower systolic blood pressure, higher respiratory rate, higher urea nitrogen level (all P 150) had a mortality rate of 59.0% at 30 days and 78.8% at 1 year. Patients with higher 1-year risk scores had reduced survival at all times up to 1 year (log-rank, P Conclusions Among community-based heart failure patients, factors identifiable within hours of hospital presentation predicted mortality risk at 30 days and 1 year. The externally validated predictive index may assist clinicians in estimating heart failure mortality risk and in providing quantitative guidance for decision making in heart failure care.
Key findings
- Results The mortality rates for the derivation cohort and validation cohort, respectively, were 8.9% and 8.2% in hospital, 10.7% and 10.4% at 30 days, and 32.9% and 30.5% at 1 year.
Why it matters
This study built and validated a model that predicts death within 30 days and 1 year for patients hospitalized with heart failure, using information available when they arrive at the hospital. It concerns heart failure outcomes and does not address treating, curing, or preventing Alzheimer's disease.
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Study details
- Participants2,624
- Effect size8.9%; 8.2%; 10.7%
- Evidence strengthModerate
How this study scored 65/100
Published in a top-tier journal. Scored zero for study design and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (JAMA) |
| Journal's citation record | 4 / 4 | JAMA: journal h-index 1,011 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2003 — older than 20 years, still counted |
| Sample size | 3 / 4 | 2,624 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 7 / 7 | Cited 1,274 times (OpenAlex, 2026-10-10) |
| Citations per year | 5 / 5 | 51.0 citations a year over 25 year(s) since 2003 |
| Impact for its field and year | 5 / 6 | Cited 22.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 3 / 4 | Cited 50 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Jack V. Tu: h-index 102 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University Health Network: institution h-index 870 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 14625335) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 65 / 100 | — |
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Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Lee, D. S., Austin, P. C., Rouleau, J. L., Liu, P. P., Naimark, D., & Tu, J. V. (2003). Predicting mortality among patients hospitalized for heart failure: derivation and validation of a clinical model. JAMA. https://doi.org/10.1001/jama.290.19.2581
Vancouver
Lee DS, Austin PC, Rouleau JL, Liu PP, Naimark D, Tu JV. Predicting mortality among patients hospitalized for heart failure: derivation and validation of a clinical model. JAMA. 2003. doi:10.1001/jama.290.19.2581. PMID: 14625335.
BibTeX
@article{lee2003-14625335,
author = {Lee, D. S. and Austin, P. C. and Rouleau, J. L. and Liu, P. P. and Naimark, D. and Tu, J. V.},
title = {{Predicting mortality among patients hospitalized for heart failure: derivation and validation of a clinical model}},
journal = {JAMA},
year = {2003},
doi = {10.1001/jama.290.19.2581},
pmid = {14625335},
url = {https://doi.org/10.1001/jama.290.19.2581}
}
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