Barcelona Ciutat Primary Care professionals develop a tool that predicts the risk of hospitalization or death of patients suffering from cardiac decompensation
This risk calculator is of practical application in the clinical work of primary care and the result helps the health professional to make decisions at the same time. Its development has required research work over the last eight years and the participation of patients and professionals from 10 European countries.
The family and community doctors of the Barcelona City Primary Care (APBCN) of the ICS and members of the Cardiovascular Research in Primary Care group (GRECAP) of the IDIAPJGol, José María Verdú and Miguel Ángel Muñoz, have led the creation of a tool that allows predict the short-term risk of hospitalization or death in a person with decompensated heart failure. Professionals from family medicine, nursing and administrative staff from APBCN have collaborated in the project. This risk calculator is of practical application to the clinical work of primary care, because the data it requires can be easily obtained in the consultation or home visit, and the result helps the health professional to make decisions at the same time. Currently, steps are being taken to implement the tool and to facilitate safe access to primary care professionals.
Cardiac bankruptcy is the most important cause of hospitalization in the elderly and has a high mortality during the year following a decompensation. In addition, most of these people are cared for in primary care by medical or nursing professionals.
The tool is called HEFESTOS, which stands for Heart Failure Stratification and Outcomes. Its development has required research work over the last eight years with the aim of creating and validating the predictive model of hospitalization or mortality using clinical and sociodemographic variables that are easy to record or measure in primary care, such as gender, hospitalizations during last year, heart rate, oxygen saturation or respiratory distress, among others.
Once the data has been entered, the calculator offers the probability of hospitalization or death thirty days after the decompensation. The results are grouped into three levels: low risk (percentage less than 5%), medium risk (between 5 and 20%) and high risk (more than 20%).
The forecasts of the risk calculator are supported by a collaborative study with patients treated in primary care, diagnosed with heart failure, who received a 30-day follow-up after suffering an episode of decompensation of their disease.
More than 500 patients from fourteen APBCN teams have participated in this study, as well as 250 patients from nine other countries integrated into the European General Practice Research Network(EGPRN): Germany, Bulgaria, Croatia, Slovenia, France, Hungary, Ireland, Italy and Sweden.
The study has been presented with great acceptance by the scientific community at various medical conferences and has recently been published in 'ESC Heart Failure', the open access journal of the Heart Failure Association of the European Society of Cardiology.
