Heart failure & cardiomyopathiesCohort study
Predicting Heart Failure Outcomes Using Patient-Reported Health Status
- Cohort study
Authors' conclusion
In outpatient heart failure care, lower KCCQ-OS scores were strongly associated with increased hospitalizations and mortality, with the greatest risk among patients with scores <25. Noncompletion of the KCCQ-12 was itself associated with worse outcomes. The KCCQ-OS score was the dominant predictor of 90-day hospitalizations and cumulative mortality in machine learning models
Study context
- Population
- Patients assigned the KCCQ-12 in outpatient HF clinics, July 2019 through March 20242,888 (66%) completed ≥1 questionnaire
- Participants
- 4,406 patients
- Exposure
- KCCQ-OS score <25 vs ≥75
- Outcome
- 90-day hospitalization and cumulative mortality
Main finding
As reported in the abstract
KCCQ-OS <25 vs KCCQ-OS ≥75Estimate (95% CI)
90-day hospitalization, adjusted
OR 3.49(2.50–4.90)
cumulative mortality, adjusted
HR 3.09(2.29–4.17)
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | |
|---|---|---|
| KCCQ-12 noncompletion — Noncompletion vs KCCQ-OS ≥75 · 90-day hospitalization, adjusted | OR 1.72 (95% CI 1.46–2.02) | |
| KCCQ-12 noncompletion — Noncompletion vs KCCQ-OS ≥75 · 1-year mortality, adjusted | HR 1.52 (95% CI 1.25–1.84) | |
| 0.512Ratio (log scale) |
KCCQ-OS score
- Median KCCQ-OS score (Q1-Q3: 35.4-81.8)
- 59.4
Machine learning prediction (KCCQ-OS most important feature)
- XGBoost, 90-day hospitalizations: AUC
- 0.760 (95% CI 0.706-0.811)
- Random survival forest, cumulative mortality: C-index
- 0.783 (95% CI 0.742-0.824)
Original publication
Predicting Heart Failure Outcomes Using Patient-Reported Health Status. J Am Coll Cardiol. Published 17 June 2025. doi:10.1016/j.jacc.2025.03.545
Summarised from the published abstract; every number is checked against it