VEXUS Score as a Tool for Guiding Treatment and predicting short term outcome in decompensated Congestive Heart Failure

Background: Systemic venous congestion is a key pathophysiological mechanism in congestive heart failure and is strongly associated with worsening renal function, diuretic resistance, and adverse clinical outcomes. Conventional clinical assessment methods frequently fail to accurately quantify congestion severity. Objective: To evaluate the role of the Venous Excess Ultrasound (VEXUS) score in assessing venous congestion and guiding management during hospitalization and early post-discharge follow-up in patients with congestive heart failure. Methods: This prospective observational study included 169 patients admitted with decompensated congestive heart failure. VEXUS score assessment was performed using point-of-care ultrasound on admission, at discharge, and one week after discharge. Clinical characteristics, laboratory parameters, echocardiographic findings, treatment requirements, and short-term outcomes were recorded and analyzed. Results: Higher VEXUS grades on admission were significantly associated with impaired renal function, increased diuretic requirements, diuretic resistance, and higher mortality rates. Improvement in VEXUS grade during hospitalization correlated with improved renal parameters, better functional status, and enhanced quality-of-life scores at discharge and follow-up. Conclusion: The VEXUS score is a practical, non-invasive bedside tool that provides objective assessment of venous congestion optimizing decongestive therapy in patients with congestive heart failure and predict the short term outcome .