Objective The Intermountain Risk Score (IMRS) was evaluated for validation as a mortality predictor and compared with the American Heart Association’s Get With The Guidelines—Heart Failure (GWTG-HF) risk score in a rural heart failure (HF) population. Background IMRS predicts mortality in general populations using common, inexpensive laboratory tests, patient age and sex, but requires validation in patients with HF. Methods Individuals were selected from the GWTG-HF registry at Essentia Health. This included consecutive HF inpatients age ≥18 years admitted July 2017–June 2019. IMRS was calculated using sex-specific weightings of the complete blood count, basic metabolic profile, and age. Results A total of 703 individuals (mean age: 74.12, 44.38% female) were studied. The 30-day IMRS predicted 30-day mortality for both sexes (females n=312: OR=1.19 (95% CI 1.08 to 1.32) per +1, p<0.001; males n=391: OR=1.23 (CI 1.12 to 1.36) per +1, p<0.001). The GWTG-HF risk score (only available in n=300, 42.7%) was independent of IMRS for 30-day mortality (OR=1.11 (CI 1.06 to 1.16) per +1, p<0.001). Using thresholds in bivariate modelling, IMRS (high vs low risk, OR=8.25 (CI 2.19 to 31.09), p=0.002) and the GWTG-HF score (tertile 3 vs 1: OR=2.18 (CI 0.84 to 5.68), p=0.11) independently predicted mortality. In multivariable analyses including covariables, IMRS (high vs low risk: OR=6.69 (CI 1.75 to 25.60), p=0.005) and the GWTG-HF score (tertile 3 vs 1: OR=2.62 (CI 0.96 to 7.12), p=0.06) remained predictors of mortality. Results were similar for 1-year mortality. Conclusions The IMRS and GWTG-HF scores predicted mortality of patients with HF in a large rural healthcare system. Future study of these scores as initial clinical risk estimators for evaluating their utility in improving patient health outcomes and increasing cost effectiveness is warranted. Data are available upon reasonable request. The data underlying this article cannot be shared publicly due to US privacy laws. The data will be shared contractually on reasonable request to Dr. Benziger at Catherine.Benziger@EssentiaHealth.org.

中文翻译：

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山间风险评分的验证并遵循指南——心力衰竭评分预测死亡率

目的 山间风险评分 (IMRS) 被评估作为死亡率预测因子的有效性，并与美国心脏协会的“遵守指南”- 农村心力衰竭 (HF) 人群的心力衰竭 (GWTG-HF) 风险评分进行比较。背景 IMRS 使用普通、廉价的实验室测试、患者年龄和性别来预测一般人群的死亡率，但需要在 HF 患者中进行验证。方法 从 Essentia Health 的 GWTG-HF 登记处选择个体。这包括 2017 年 7 月至 2019 年 6 月入院的年龄≥18 岁的连续 HF 住院患者。 IMRS 使用全血细胞计数、基本代谢特征和年龄的性别特异性加权计算。结果 总共研究了 703 个人（平均年龄：74.12，44.38% 女性）。30 天 IMRS 预测了两性的 30 天死亡率（女性 n=312：OR=1。19 (95% CI 1.08 to 1.32) per +1, p<0.001; 男性 n=391：OR=1.23（CI 1.12 至 1.36）/+1，p<0.001）。GWTG-HF 风险评分（仅适用于 n=300，42.7%）与 IMRS 的 30 天死亡率无关（OR=1.11（CI 1.06 至 1.16）/+1，p<0.001）。在双变量建模中使用阈值，IMRS（高风险与低风险，OR=8.25（CI 2.19 至 31.09），p=0.002）和 GWTG-HF 评分（三分位 3 与 1：OR=2.18（CI 0.84 至 5.68），p =0.11) 独立预测死亡率。在包括协变量、IMRS（高风险与低风险：OR=6.69（CI 1.75 至 25.60），p=0.005）和 GWTG-HF 评分（三分位 3 与 1：OR=2.62（CI 0.96 至 7.12），p 的多变量分析中=0.06) 仍然是死亡率的预测因子。1 年死亡率的结果相似。结论 IMRS 和 GWTG-HF 评分可预测大型农村医疗保健系统中 HF 患者的死亡率。未来有必要将这些分数作为初始临床风险估计值进行研究，以评估其在改善患者健康结果和提高成本效益方面的效用。可应合理要求提供数据。由于美国隐私法，本文所依据的数据不能公开共享。数据将在合理要求下以合同方式共享给 Benziger 博士，电子邮件地址为 Catherine.Benziger@EssentiaHealth.org。