title: Predicting hospitalization and mortality in patients with heart failure: The BARDICHE-index.
abstract: BACKGROUND
  Prediction of events in chronic heart failure (CHF) patients is still difficult and available scores are often complex to calculate. Therefore, we developed and validated a simple-to-use, multidimensional prognostic index for such patients.
  
  
  METHODS
  A theoretical model was developed based on known prognostic factors of CHF that are easily obtainable: Body mass index (B), Age (A), Resting systolic blood pressure (R), Dyspnea (D), N-termInal pro brain natriuretic peptide (NT-proBNP) (I), Cockroft-Gault equation to estimate glomerular filtration rate (C), resting Heart rate (H), and Exercise performance using the 6-min walk test (E) (the BARDICHE-index). Scores were given for all components and added, the sum ranging from 1 (lowest value) to 25 points (maximal value), with estimated risk being highest in patients with highest scores. Scores were categorized into three groups: a low (≤8 points); medium (9-16 points), or high (>16 points) BARDICHE-score. The model was validated in a data set of 1811 patients from two prospective CHF-cohorts (median follow-up 887days). The primary outcome was 5-year all-cause survival. Secondary outcomes were 5-year survival without all-cause hospitalization and 5-year survival without CHF-related hospitalization.
  
  
  RESULTS
  There were significant differences between BARDICHE-risk groups for mortality (hazard ratio=3.63 per BARDICHE-group, 95%-CI 3.10-4.25), mortality or all-cause hospitalization (HR=2.00 per BARDICHE-group, 95%-CI 1.83-2.19), and mortality or CHF-related hospitalization (HR=3.43 per BARDICHE-group, 95%-CI 3.01-3.92; all P<10-50). Outcome was predicted independently of left ventricular ejection fraction (LVEF) and gender.
  
  
  CONCLUSIONS
  The BARDICHE-index is a simple multidimensional prognostic tool for patients with CHF, independently of LVEF.
authors.affiliation: Department of Cardiology, CARIM; Maastricht University Medical Centre + (MUMC+), Maastricht, The Netherlands; Department of Research & Education, CIRO, Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands. Electronic address: n.lencer@mumc.nl.
authors.forename: Nicole H M K
authors.initials: NHMK
authors.lastname: Uszko-Lencer
authors.affiliation: Cardiologist, Department of Cardiology, Angiology, Pulmonology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Lutz
authors.initials: L
authors.lastname: Frankenstein
authors.affiliation: Department of Research & Education, CIRO, Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands; REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
authors.forename: Martijn A
authors.initials: MA
authors.lastname: Spruit
authors.affiliation: Department of Cardiology, Kantonsspital St.Gallen, Switzerland.
authors.forename: Micha T
authors.initials: MT
authors.lastname: Maeder
authors.affiliation: Department of Cardiology, University Hospital, Liestal, Switzerland.
authors.forename: Marc
authors.initials: M
authors.lastname: Gutmann
authors.affiliation: Division of Cardiology, Fondazione "Cardiocentro Ticino", Lugano, Switzerland.
authors.forename: Stefano
authors.initials: S
authors.lastname: Muzzarelli
authors.affiliation: Department of Cardiology, University Hospital, Basel, Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Osswald
authors.affiliation: Department of Cardiology, University Hospital, Basel, Switzerland.
authors.forename: Matthias E
authors.initials: ME
authors.lastname: Pfisterer
authors.affiliation: Cardiologist, Department of Cardiology, Angiology, Pulmonology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Zugck
authors.affiliation: Department of Cardiology, CARIM; Maastricht University Medical Centre + (MUMC+), Maastricht, The Netherlands; Department of Cardiology, University Hospital, Basel, Switzerland.
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Brunner-La Rocca
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis* / Q000401:mortality* / Q000503:physiopathology; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index
keywords: Chronic heart failure; Prognostic model; Survival