Risk Assessment of Echocardiography Parameter Scoring System for 1 Year Re-admission in Patients With Left Ventricular Systolic Dysfunction / 中国循环杂志

ABSTRACT

Objective: To establish an echocardiography parameter scoring system for assessing the risk of 1 year re-admission in patients with left ventricular systolic dysfunction (LVSD). Methods: A total of 412 chronic LVSD patients treated in our hospital from 2007-01 to 2016-01 were studied and the end point event was 1 year re-admission. The data included in 280 patients from 2007-01 to 2014-12 for establishing the scoring system and 132 patients from 2015-01 to 2016-01 for verifying the system. Based on 7 echocardiography parameters, the patients were divided into 7 sets of groups ① Left ventricular diameter (LVD) Group0, n=290 and Group1, n=122;② Mitrial regurgitation (MR) Group0, n=203, Group1, n=138 and Group2, n=71; ③ Tricuspid regurgitation (TR) Group0, n=302, Group1, n=90 and Group2, n=20; ④ LVEF Group0, n=272 and Group1, n=140; ⑤ Pulmonary artery systolic pressure Group0, n=282 and Group1, n=130; ⑥ Hydropericardium Group0, n=347 and Group1, n=65; ⑦ HydrothoraxGroup 0, n=261, Group1, n=86 and Group2, n=65. The parameters were identified by COX regression analysis, weighted value of scoring system was calculate by hazard ratio (HR), predictive value for1 year re-admission was assess by ROC curve and finally, scoring integration was verified by validation data group. Results: The integration score was calculated as follows LVD>60mm=1 point; TR Group1=1 point and Group2=3 points; MR Group1=2 points and Group2=4 points; Hydrothorax Group1=2 points and Group2=3 points;Hydropericardium=1 point. COX regression analysis indicated that for 1 year re-admission HR=1.552 in Group1 vs Group0, HR=3.374 in Group2 vs Group0 and HR=4.562 in Group3 vs Group0, all P<0.05. The AUC of ROC for establishing the data was 70.0% (95% CI 0.640-0.761) and for verifying the data was 70.4% (95% CI 0.616-0.792); the best integration score was 4 points. Conclusion: Echocardiography parameter scoring system may better predict the risk of 1 year re-admission in LVSD patients which is superior to single echocardiography parameter.