Abstract P238: Long-Term Survival Trends in Hospitalized Heart Failure Patients
Bibliographic record
Abstract
Background: Long-term survival data on patients with heart failure (HF) in community-based populations are limited. Preserved ejection fraction (PEF) is present in 50-60% of HF patients. We examined whether trends in long-term survival differed between HF patients with preserved (ejection fraction >/= 45) and reduced ejection fraction (REF) in the context of modern treatment. Methods: The Minnesota Heart Survey, a community-based population study conducted in the Minneapolis-St. Paul metropolitan area, abstracted a random sample of hospital records for patients aged 35-84 with a discharge diagnosis of HF in 1995 and 2000. In the absence of a gold standard diagnosis of HF, hospitalization records that met at least four of six published classification algorithm definitions were considered HF related. Mortality was ascertained from medical records and by linkage to death certificates from the Department of Health. Kaplan-Meier was used for unadjusted survival and Cox proportional hazards regression was used to calculate adjusted hazard ratios (HR). Results: In 1995 1269 HF patients (PEF, n = 423; REF, n = 846) and in 2000 1103 HF patients (PEF, n = 413; REF, n = 690) were identified. The prevalence of hypertension, diabetes mellitus and hyperlipidemia were significantly higher in 2000; the utilization of ACE-Inhibitors, beta-blockers and revascularization were also significantly greater in 2000. In 1995, the unadjusted 9-year survival was 21% in REF and 28% in PEF; in 2000 these numbers were 28% in REF and 29% in PEF (Figure). After adjustment for sex and age the HR for 9-year mortality in 1995 was 0.77 (95% CI: 0.68 - 0.89) for HF patients with PEF compared to REF, p = 0.0003; in 2000 the adjusted HR for 9-year mortality in patients with PEF compared to REF was 0.95 (95%CI: 0.82 - 1.10), p = 0.48. Conclusion: Survival after a HF related hospitalization is low with less than 30% of patients surviving nine years. The increased utilization of ACE-Inhibitors and beta-blockers may partially explain the improved survival among HF patients with REF.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".