title: The Seattle Heart Failure Model predicts survival in patients with cardiac resynchronization therapy: a validation study.
abstract: BACKGROUND
  The Seattle Heart Failure Model (SHFM) predicts mortality in patients with heart failure, but no study has investigated model performance in subjects with cardiac resynchronization therapy (CRT).
  
  
  RESULTS
  Prospectively collected registry data of 427 patients with CRT were used for the evaluation of the discrimination and calibration performance of the SHFM. The primary end point was all-cause mortality. Calibration profile was assessed with the use of Hosmer-Lemeshow tests, and discrimination was assessed by calculating areas under receiver operating characteristic curves (AUCs) derived from the model. Mean (SD) age of the study population was 61.2 (11.1) years (72.6% male). During a median follow-up of 24.7 months, 16.9% (72/427) of the patients reached the primary end point, with observed outcomes of 34/303, 54/234, and 72/97 at years 1, 2, and 5, respectively. No evidence of insufficient fit was found in any calibration tests. AUC estimates in all subjects were 0.7377 (95% CI 0.6575-0.8179) at year 1, 0.7936 (95% CI 0.7317-0.8556) at year 2, and 0.7572 (95% CI 0.6455-0.8689) at year 5.
  
  
  CONCLUSIONS
  SHFM offers an accurate prediction of survival in patients with CRT, with good observed calibration and AUC estimates indicating discrimination performance similar to those found by earlier validation studies.
authors.affiliation: Department of Cardiology, University of Debrecen, Debrecen, Hungary. marcellclemens@gmail.com
authors.forename: Marcell
authors.initials: M
authors.lastname: Clemens
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Szegedi
authors.forename: László
authors.initials: L
authors.lastname: Kardos
authors.forename: Edina
authors.initials: E
authors.lastname: Nagy-Baló
authors.forename: Gábor
authors.initials: G
authors.lastname: Sándorfi
authors.forename: István
authors.initials: I
authors.lastname: Edes
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Csanádi
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D058406:Cardiac Resynchronization Therapy / Q000401:mortality*; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D011446:Prospective Studies; D012372:ROC Curve; D012042:Registries; D018570:Risk Assessment / Q000379:methods
chemical_list: D000959:Antihypertensive Agents; D004232:Diuretics