| Autor | Rassi Jr., Anis | |
| Autor | Rassi, Anis | |
| Autor | Little, William C. | |
| Autor | Xavier, Sergio Salles | |
| Autor | Rassi, Sergio G. | |
| Autor | Rassi, Alexandre G. | |
| Autor | Rassi, Gustavo G. | |
| Autor | Hasslocher-Moreno, Alejandro Marcel | |
| Autor | Sousa, Andrea Silvestre de | |
| Autor | Scanavacca, Mauricio I. | |
| Data de acesso | 2022-11-04T12:35:35Z | |
| Data de disponibilização | 2022-11-04T12:35:35Z | |
| Data do publicação | 2006 | |
| Citação | RASSI JUNIOR, Anis et al. Development and Validation of a Risk Score for Predicting Death in Chagas’ Heart Disease. The New England Journal of Medicine, v. 355, n. 8, p. 799-808, 2006. | en_US |
| ISSN | 0028-4793 | en_US |
| URI | https://www.arca.fiocruz.br/handle/icict/55455 | |
| Idioma | eng | en_US |
| Editor | Massachusetts Medical Society | en_US |
| Direito Autoral | open access | en_US |
| Título | Development and Validation of a Risk Score for Predicting Death in Chagas' Heart Disease | en_US |
| Tipo do documento | Article | en_US |
| DOI | 10.1056/NEJMoa053241 | |
| Resumo em Inglês | Background: Chagas' disease is an important health problem in Latin America, and cardiac involvement is associated with substantial morbidity and mortality. We developed a model to predict the risk of death in patients with Chagas' heart disease.
Methods: We retrospectively evaluated 424 outpatients from a regional Brazilian cohort. The association of potential risk factors with death was tested by Cox proportional-hazards analysis, and a risk score was created. The model was validated in 153 patients from a separate community hospital.
Results: During a mean follow-up of 7.9 years, 130 patients in the development cohort died. Six independent prognostic factors were identified, and each was assigned a number of points proportional to its regression coefficient: New York Heart Association class III or IV (5 points), evidence of cardiomegaly on radiography (5 points), left ventricular systolic dysfunction on echocardiography (3 points), nonsustained ventricular tachycardia on 24-hour Holter monitoring (3 points), low QRS voltage on electrocardiography (2 points), and male sex (2 points). We calculated risk scores for each patient and defined three risk groups: low risk (0 to 6 points), intermediate risk (7 to 11 points), and high risk (12 to 20 points). In the development cohort, the 10-year mortality rates for these three groups were 10 percent, 44 percent, and 84 percent, respectively. In the validation cohort, the corresponding mortality rates were 9 percent, 37 percent, and 85 percent. The C statistic for the point system was 0.84 in the development cohort and 0.81 in the validation cohort.
Conclusions: A simple risk score was developed to predict death in Chagas' heart disease and was validated in an independent cohort. | en_US |
| Afiliação | Anis Rassi Hospital. Division of Cardiology. Goiânia, GO, Brazil. | en_US |
| Afiliação | Anis Rassi Hospital. Division of Cardiology. Goiânia, GO, Brazil. | en_US |
| Afiliação | Wake Forest University School of Medicine. Section of Cardiology. Winston-Salem. NC, USA. | en_US |
| Afiliação | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Afiliação | Anis Rassi Hospital. Division of Cardiology. Goiânia, GO, Brazil. | en_US |
| Afiliação | Anis Rassi Hospital. Division of Cardiology. Goiânia, GO, Brazil. | en_US |
| Afiliação | Anis Rassi Hospital. Division of Cardiology. Goiânia, GO, Brazil. | en_US |
| Afiliação | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Afiliação | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Afiliação | Universidade de São Paulo. Faculdade de Medicina. Instituto do Coração. São Paulo, SP, Brasil. | en_US |
| Palavras-chave em inglês | Chagas disease | en_US |
| Palavras-chave em inglês | Chagas' heart disease | en_US |
| Palavras-chave em inglês | Risk of death | en_US |
| Palavras-chave em inglês | Brazil | en_US |
