Neutrophil to Lymphocyte Ratio, NTproBNP and Six-minute Walk Test as Predictors of Readmission and Mortality in Patients with Heart Failure: A Prospective Observational Study

Introduction: Heart Failure (HF) is a leading cause of morbidity and mortality worldwide, with a high-risk of hospital readmission. Identifying reliable prognostic markers is crucial for optimising clinical management. N-terminal pro-B-type natriuretic peptide (NTproBNP), Neutrophil-To-Lymphocyte Ratio (NLR), and the Six-Minute Walk Test (6MWT) have emerged as key predictors of HF outcomes. Aim: The present study evaluates the predictive value of NTproBNP, NLR, and the 6MWT in assessing mortality and readmission risks in HF patients. Materials and Methods: In the present prospective observational study, 170 HF patients were enrolled over 18 months. NTproBNP and NLR were measured at admission; 6MWT was conducted at discharge. Patients were followed for 90 days to assess mortality and readmission. Receiver Operating Characteristic (ROC) analysis determined cut-off values and predictive accuracy. Results: Mortality occurred in 14 patients (8.2%) and readmission in 19 patients (11.2%). NTproBNP levels were significantly higher in mortality (28,114.29±6799.08 pg/mL) and readmission groups (21,242.63±9553.81 pg/mL) with AUCs of 0.98 and 0.92, respectively (p<0.0001). NLR was elevated in mortality (6.70±2.53; AUC=0.64) and readmission groups (7.88±4.93; AUC=0.67). 6MWT distances were reduced in mortality (170.00±49.92 m; AUC=0.978) and readmission (214.74±73.66 m; AUC=0.915). Conclusion: NTproBNP and 6MWT are effective prognostic markers in HF, enhancing risk stratification. NTproBNP was the most predictive, 6MWT assessed functional status, and NLR reflected inflammation’s role.