Key result
B-line score >3 at discharge linked to ~372% higher 30-day rehospitalization risk in AHF.
Why the study?
Patients with acute heart failure exhibit high rates of early rehospitalization and significant mortality, making identification of high-risk patients prone to exacerbation important for early intervention.
Do lung and inferior vena cava point-of-care ultrasonography, NT-pro-BNP, and discharge body weight predict 30-day rehospitalization in adult patients with acute heart failure?
Observational (n=100)
No
Do lung and inferior vena cava point-of-care ultrasonography, NT-pro-BNP, and discharge body weight predict 30-day rehospitalization in adult patients with acute heart failure?
Lung ultrasound assessment of B-lines at discharge identifies acute heart failure patients at high risk for 30-day rehospitalization, whereas NT-pro-BNP and IVC collapsibility do not.
B-line score >3 at AHF discharge may aid risk stratification; hypothesis-generating and should not yet change practice.
Background: Patients with acute heart failure exhibit high rates of early rehospitalization accompanied by significant mortality. Therefore, identifying high-risk patients who are prone to disease exacerbation may enable early therapeutic interventions for improved disease management. Methods: This single-center, prospective observational study was conducted at a Brazilian hospital. Adult patients hospitalized for acute heart failure were enrolled. On the day of hospital discharge, NT-pro-BNP and body weight data were collected, and bedside lung and inferior vena cava ultrasound examinations were performed. The patients were followed up for up to 30 days after discharge. The primary outcome was rehospitalization for acute heart failure. Results: A total of 100 patients were included in the final analysis, of whom 10% were readmitted within 30 days owing to acute heart failure. The number of patients with total B-line scores >3 in the readmitted and non-readmitted groups was 6 and 19, respectively (60% and 21%, respectively; absolute risk difference: 39%; p = 0.014). The mean inferior vena cava collapsibility index was significantly lower in readmitted compared to that in non-readmitted patients (25.5% vs. 39.8%, standard deviation: 15.4% and 18.4%, respectively; p = 0.020). However, mean body weight and mean NT-pro-BNP levels at discharge did not differ between the groups. In a multivariate logistic regression model adjusted for sex, age, discharge body weight, and left ventricular ejection fraction, a total B-lines score >3 had an odds ratio of 4.72 (95% confidence interval (CI): 1.01–22.13; p = 0.049), while the inferior vena cava collapsibility index had an odds ratio of 0.96 (95% CI: 0.91–1.01; p = 0.091). Conclusions: A total B-line score >3 at discharge in patients hospitalized for acute heart failure was associated with 30-day rehospitalization. In contrast, inferior vena cava ultrasound, discharge body weight, and NT-pro-BNP at discharge were not significant predictors of rehospitalization.
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Martins et al. (2025) conducted an observational in Acute heart failure (n=100). Total B-line score >3 at discharge vs. Total B-line score ≤3 was evaluated on Rehospitalization for acute heart failure (OR 4.72, 95% CI 1.01-22.13, p=0.049). A total B-line score >3 at discharge in patients with acute heart failure was significantly associated with 30-day rehospitalization (OR 4.72; 95% CI 1.01-22.13; p=0.049).
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