title: Long-term association between self-reported signs and symptoms and heart failure hospitalizations: the Atherosclerosis Risk In Communities (ARIC) Study.
abstract: OBJECTIVE
  Although studies of the accuracy of heart failure (HF) classification scoring systems are available, few have examined their performance when restricted to self-reported items.
  
  
  RESULTS
  We evaluated the association between a simplified version of the Gothenburg score, a validated HF score comprised of cardiac and pulmonary signs and symptoms and medication use, and incident HF hospitalizations in 15,430 Atherosclerosis Risk in Communities (ARIC) Study participants. Gothenburg scores (range: 0-3) were constructed using self-reported items obtained at study baseline (1987-89). Incident HF hospitalization over 14.7 years of follow-up was defined as the first identified hospitalization with an ICD-9 discharge code of 428 (n = 1,668). Self-reported Gothenburg scores demonstrated very high agreement with the original metric comprised of self-reported and clinical measures and were directly associated with incident HF hospitalizations: [score = 1: hazard rate ratio (HRR) = 1.23 (1.07-1.42); score = 2: HRR = 2.17 (1.92-2.43); score = 3: HRR = 3.98 (3.37-4.70)].
  
  
  CONCLUSIONS
  In a population-based cohort, self-reported Gothenburg criteria items were associated with hospitalized HF over a prolonged follow-up time. The association was also consistent across groups defined by sex and race, suggesting that this simple score deserves further study as a screening tool for the identification of individuals at high risk of HF in resource-limited settings.
authors.affiliation: Department of Epidemiology, University of North Carolina at Chapel Hill, Bank of America Center, 137 E. Franklin St, Suite 306, Chapel Hill, NC 27514, USA. christy_avery@unc.edu
authors.forename: Christy L
authors.initials: CL
authors.lastname: Avery
authors.forename: Katherine T
authors.initials: KT
authors.lastname: Mills
authors.forename: Lloyd E
authors.initials: LE
authors.lastname: Chambless
authors.forename: Patricia P
authors.initials: PP
authors.lastname: Chang
authors.forename: Aaron R
authors.initials: AR
authors.lastname: Folsom
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Mosley
authors.forename: Hanyu
authors.initials: H
authors.lastname: Ni
authors.forename: Wayne D
authors.initials: WD
authors.lastname: Rosamond
authors.forename: Lynne
authors.initials: L
authors.lastname: Wagenknecht
authors.forename: Joy
authors.initials: J
authors.lastname: Wood
authors.forename: Gerardo
authors.initials: G
authors.lastname: Heiss
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012647:Self-Assessment; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data