Risk Model Construction And Prognostic Assessment Of Type 2 Cardiorenal Syndrome In Patients With Chronic Heart Failure

Objective:To study the risk factors of type 2 cardiorenal syndrome(CRS2)in patients with chronic heart failure(CHF),construct and verify the risk prediction model of CRS2 in CHF patients and analyze its prognosis.Methods:A total of 663 patients with CHF who visited the Heart Center of the First Affiliated Hospital of Xinjiang Medical University from January to June 2021 were randomly divided into modeling group(n=466)and validation group(n=197)according to the ratio of 7:3.The data of modeling group were divided into CRS2 group(n=104)with e GFR<60 m L/min 1.73 m~2and non-CRS2 group(n=362)with e GFR≥60 m L/min 1.73 m~2.Univariate and multivariate logistic regression analysis were used to analyze the data of modeling group and obtain the independent risk factors of CRS2 in CHF patients.R software was used to construct the risk nomogram model,and the model was validated.Finally,the prognosis of the two groups was analyzed and the risk factors of rehospitalization due to CHF within 1 year were analyzed.Results:(1)Multivariate logistic regression showed that age≥75 years,hypertension,NYHA class IV,anemia and NT-pro BNP were significantly different(P<0.05),which were independent risk factors of CRS2 in CHF patients.The established risk prediction model had good discrimination,calibration and certain clinical practical value.(2),there were significant differences in all-cause rehospitalization and all-cause death within 1 year between the non-CRS2 and CRS2 groups(P<0.05);multivariate logistic regression showed that age≥75 years,NT-pro BNP,and CRS2 were significantly different in whether CHF patients had psychogenic rehospitalization within 1 year(P<0.05)and were independent risk factors for psychogenic rehospitalization within 1 year in CHF patients.Conclusion:(1)According to the contribution of each risk factor to CRS2 in CHF,the risk prediction model constructed in this study can accurately and effectively predict the individualized risk prediction probability of CRS2 in CHF and assist clinicians in screening high-risk patients.(2)CRS2 not only has higher rehospitalization rate and mortality than non-CRS2,but also CRS2 is an independent risk factor for rehospitalization within 1 year in CHF patients,and its prognosis is poor.