Congestion score index assessed by chest radiography in geriatric patients as a new predictor of mortality in patients with acute heart failure

Introduction Heart failure (HF) has been associated with higher mortality rates, morbidity, and extended hospital stays among older adults. All technical terms will be defined upon first use. Our study aims to exhibit how the Congestion Score Index (CSI), derived from chest radiography (CXR), can help evaluate mortality in geriatric patients with acute decompensated HF by assessing pulmonary congestion. Patients and methods Our research is a retrospective investigation conducted at a single center, involving elderly patients with decompensated HF, who arrived at the Emergency Department from January 1, 2021 to January 1, 2023. Two physicians captured measurements from CXRs in six different regions and computed CSI scores. The patients were categorized based on their CSI score, with a median value of 2.5, and the effect on mortality was analyzed. Results A total of 130 patients meeting the inclusion criteria were enrolled in the study, of whom 50% were male. The mean congestion score was computed as 2.28 ± 0.72. After examining the median CSI values of the patients, it was discovered that the high CSI group had significantly higher scores than those with a lower average age (P = 0.032). Moreover, when assessed based on mortality percentage, a significantly higher rate of mortality was detected in the high CSI group (P = 0.002). Conclusion Our study has displayed the significance of the CSI score as an indicator of mortality in HF patients. CSI can be simple and easily calculated from CXR.