June 4, 2026Journal of the American College of Cardiology602 citations
Predictors of In-Hospital Mortality in Patients Hospitalized for Heart Failure
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Key Result
Older age, low systolic blood pressure or sodium, and elevated heart rate or creatinine predicted a 3.8% in-hospital mortality rate among 48,612 patients hospitalized with heart failure.
Key Points
- This research aims to identify key predictors associated with in-hospital mortality for patients with heart failure.
- Analyzed patient records from a large hospital database
- Identified clinical and demographic factors as predictors
- Utilized statistical analysis to determine significance
- Found that older age is a significant predictor of increased in-hospital mortality
- Correlating comorbid conditions, such as diabetes and renal failure, with higher mortality rates
- Identified specific clinical outcomes that relate to higher risk during hospitalization
Study Design
Type
Observational (n=48,612)
Multicenter
Yes
Structured PICO
P
Population
48,612 patients hospitalized with heart failure across 259 U.S. hospitals.
O
Outcome
In-hospital mortalityhard clinical
A risk-prediction algorithm using routine admission variables can identify hospitalized heart failure patients at high risk for in-hospital mortality.
Abstract
OBJECTIVES: The aim of this study was to develop a clinical model predictive of in-hospital mortality in a broad hospitalized heart failure (HF) patient population. BACKGROUND: Heart failure patients experience high rates of hospital stays and poor outcomes. Although predictors of mortality have been identified in HF clinical trials, hospitalized patients might differ greatly from trial populations, and such predictors might underestimate mortality in a real-world population. METHODS: The OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure) is a registry/performance improvement program for patients hospitalized with HF in 259 U.S. hospitals. Forty-five potential predictor variables were used in a stepwise logistic regression model for in-hospital mortality. Continuous variables that did not meet linearity assumptions were transformed. All significant variables (p < 0.05) were entered into multivariate analysis. Generalized estimating equations were used to account for the correlation of data within the same hospital in the adjusted models. RESULTS: Of 48,612 patients enrolled, mean age was 73.1 years, 52% were women, 74% were Caucasian, and 46% had ischemic etiology. Mean left ventricular ejection fraction was 0.39 +/- 0.18. In-hospital mortality occurred in 1,834 (3.8%). Multivariable predictors of mortality included age, heart rate, systolic blood pressure (SBP), sodium, creatinine, HF as primary cause of hospitalization, and presence/absence of left ventricular systolic dysfunction. A scoring system was developed to predict mortality. CONCLUSIONS: Risk of in-hospital mortality for patients hospitalized with HF remains high and is increased in patients who are older and have low SBP or sodium levels and elevated heart rate or creatinine at admission. Application of this risk-prediction algorithm might help identify patients at high risk for in-hospital mortality who might benefit from aggressive monitoring and intervention.
Cite This Study
Abraham et al. (2008) conducted an observational in Heart failure (n=48,612). Clinical predictors (age, heart rate, systolic blood pressure, sodium, creatinine) was evaluated on In-hospital mortality. Older age, low systolic blood pressure or sodium, and elevated heart rate or creatinine predicted a 3.8% in-hospital mortality rate among 48,612 patients hospitalized with heart failure.