TY  - JOUR
N1  - This work was supported by U.S. National Institutes of Health/National Heart, Lung and Blood Institute (NIH/NHLBI) grant
K23HL123533) (to Dr. Platz) and project grant PG/13/17/30050 (to
Drs. Campbell and McMurray) from the British Heart Foundation.
ID  - enlighten324955
UR  - https://eprints.gla.ac.uk/324955/
A1  - Espersen, Caroline
A1  - Campbell, Ross T.
A1  - Claggett, Brian L.
A1  - Lewis, Eldrin F.
A1  - Docherty, Kieran F.
A1  - Lee, Matthew M.Y.
A1  - Lindner, Moritz
A1  - Brainin, Philip
A1  - Biering-S�rensen, Tor
A1  - Solomon, Scott D
A1  - McMurray, John J.V.
A1  - Platz, Elke
Y1  - 2024/07/01/
N2  - 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.
PB  - Elsevier
JF  - International Journal of Cardiology
VL  - 406
KW  - acute heart failure
KW  -  risk score
KW  -  lung ultrasound
KW  -  echocardiography.
SN  - 0167-5273
TI  - Predictors of heart failure readmission and all-cause mortality in patients with acute heart failure
AV  - restricted
ER  -