Predictors of heart failure readmission and all-cause mortality in patients with acute heart failure.
Int J Cardiol
; 406: 132036, 2024 Jul 01.
Article
in En
| MEDLINE
| ID: mdl-38599465
ABSTRACT
BACKGROUND:
Predischarge risk stratification of patients with acute heart failure (AHF) could facilitate tailored treatment and follow-up, however, simple scores to predict short-term risk for HF readmission or death are lacking.METHODS:
We sought to develop a congestion-focused risk score using data from a prospective, two-center observational study in adults hospitalized for AHF. Laboratory data were collected on admission. Patients underwent physical examination, 4-zone, and in a subset 8-zone, lung ultrasound (LUS), and echocardiography at baseline. A second LUS was performed before discharge in a subset of patients. The primary endpoint was the composite of HF hospitalization or all-cause death.RESULTS:
Among 350 patients (median age 75 years, 43% women), 88 participants (25%) were hospitalized or died within 90 days after discharge. A stepwise Cox regression model selected four significant independent predictors of the composite outcome, and each was assigned points proportional to its regression coefficient NT-proBNP ≥2000 pg/mL (admission) (3 points), systolic blood pressure < 120 mmHg (baseline) (2 points), left atrial volume index ≥60 mL/m2 (baseline) (1 point) and ≥ 9 B-lines on predischarge 4-zone LUS (3 points). This risk score provided adequate risk discrimination for the composite outcome (HR 1.48 per 1 point increase, 95% confidence interval 1.32-1.67, p < 0.001, C-statistic 0.70). In a subset of patients with 8-zone LUS data (n = 176), results were similar (C-statistic 0.72).CONCLUSIONS:
A four-variable risk score integrating clinical, laboratory and ultrasound data may provide a simple approach for risk discrimination for 90-day adverse outcomes in patients with AHF if validated in future investigations.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Patient Readmission
/
Heart Failure
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Int J Cardiol
/
Int. j. cardiol
/
International journal of cardiology
Year:
2024
Document type:
Article
Country of publication:
Netherlands