Construction and validation of a short-term prognostic model for acute heart failure patients with preserved ejection fraction
Liang Yang
Li Shu
Song Aixiang
Wang Meng
Yan Jingjing
Liu Mengxuan
Ge Hongxia
Abstract：Objective To develop a risk prediction model for in-hospital mortality in the patients with acute heart failure with preserved ejection fraction(HFpEF).Methods Clinical data from 556 adult patients with acute HFpEF who visited the emergency departments of 28 tertiary hospitals nationwide were retrospectively collected to establish a database.Logistic regression analysis was used to identify model variables,and a visual nomogram model for in-hospital mortality risk was constructed.The bootstrap method and cohort of different periods were used for internal validation.The performance of the model was evaluated by receiver operating characteristic curve analysis and calibration curve.Results A total of 556 patients with acute HFpEF who were first diagnosed in the emergency department were used for model training,with an average age of 71.1 years,and 29 cases died.After multivariate Logistic regression analysis,four variables including mechanical ventilation,blood lactic acid,serum albumin and alanine aminotransferase were finally identified as the risk factors of in-hospital mortality in the patients with acute HFpEF.The nomogram prediction model was further established,and the area under the curve(AUC)was 0.744,indicating that the model had good discrimination;The calibration curve showed that the model fitted well.A cohort of patients with acute HFpEF who visited the emergency department of Peking University Third Hospital from January 1,2025 to May 31,2025 was used to validate the model in the cohort of different periods.The AUC of the validation set was 0.810,indicating that the model had good discrimination;The calibration curve showed that the model had calibration performance and strong generalization ability.Conclusion This model,based on only four commonly used clinical variables,accurately predicts in-hospital mortality in acute HFpEF patients and is used for early identification of high-risk acute HFpEF patients and improve clinical prognosis.It can aid in routine clinical practice to manage acute HFpEF patients,facilitate early identification of high-risk individuals,and improve clinical outcomes.
Keywords：Acute decompensated heart failureHeart failure with preserved ejection fraction(HFpEF)In-hospital mortalityPredictive modelMechanical ventilationBlood lactic acidAlbuminAlanine aminotransferase
Publication Date：2025-11-10
Online Publishing Date：2025-12-09(First online date of this platform, not the publication date of the document)
Pages：7( 929-935 )