Key result
High admission BAN-ADHF score linked to ~75% greater all-cause mortality in ADHF.
Why the study?
The performance of the recently developed BAN-ADHF score in real-world settings remains understudied.
Does a high BAN-ADHF score predict all-cause mortality and heart failure readmission in patients with acute decompensated heart failure?
Cohort (n=2,110)
Yes
Does a high BAN-ADHF score predict all-cause mortality and heart failure readmission in patients with acute decompensated heart failure?
The BAN-ADHF score is a valuable prognostic tool for identifying acute decompensated heart failure patients at greater risk of mortality, rehospitalization, and longer hospital stays in real-world settings.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“In clinical practice, there is heterogeneity in response to loop diuretics. Diuretic resistance—the inability to achieve adequate natriuresis despite appropriate dosing—affects a substantial subset of patients and is associated with worse decongestion and worse outcomes.”
“The BAN-ADHF score 'is a great prognosticator.'”
“We know the BAN-ADHF score can accurately identify, characterize, and predict diuretic resistance among individuals with ADHF mathematically. Now we must take this medical knowledge and conduct a clinical study to evaluate whether implementing the BAN-ADHF score in our care protocols improves outcomes for patients hospitalized with acute decompensated heart failure.”
BAN-ADHF score identifies higher-risk ADHF patients for mortality and readmission; extends validation to real-world cohorts but prospective trials needed before adoption.
The BAN-ADHF score is a recently developed measure designed to predict low diuretic efficiency and adverse outcomes using eight simple routinely available clinical and laboratory variables. However, its performance in real-world settings remains understudied. This is a retrospective analysis using data from the Spanish Heart Failure Registry (RICA), a nationwide, prospective cohort of patients admitted for ADHF to internal medicine departments. Only patients with complete data to calculate the BAN-ADHF score were included. Patients were classified into low BAN-ADHF (< 12) and high BAN-ADHF (≥ 12) groups. The primary endpoint was all-cause mortality. Secondary endpoints included the composite of mortality and/or heart failure (HF) readmission and length of hospital stay. A total of 2110 were eligible. High BAN-ADHF patients (17.5%) were older, with a higher burden of comorbidities, worse functional class and a higher proportion of reduced left ventricular ejection fraction (LVEF). Additionally, high BAN-ADHF patients showed lower hemoglobin, sodium, and estimated glomerular filtration rate, together with higher levels of creatinine, potassium, CA125, and NT-proBNP. After a median follow-up of 363 days, all-cause mortality occurred in 30.3% of patients, predominantly in the high BAN-ADHF group (HR 1.75, 95% CI 1.46-2.08, p = 0.001). The composite endpoint occurred in 44.9% of patients and was more frequent in the high BAN-ADHF group (HR 1.47, 95% CI 1.24-1.76, p = 0.001). Moreover, the BAN-ADHF score was independently associated with longer hospital stays (p = 0.001). No interaction was found between LVEF and the BAN-ADHF categories. The BAN-ADHF score is a valuable prognostic tool for identifying ADHF patients at greater risk of mortality, rehospitalization, and longer hospitalization in a real-world setting. Its integration into routine care may help guide early therapeutic strategies and resource allocation.
No takes yet. Share an insight, caveat, or question.
Santamaría et al. (2026) conducted a cohort in Acute decompensated heart failure (n=2,110). High BAN-ADHF score (≥ 12) vs. Low BAN-ADHF score (< 12) was evaluated on All-cause mortality (HR 1.75, 95% CI 1.46-2.08, p=0.001). A high BAN-ADHF score (≥ 12) at admission was associated with a significantly increased risk of all-cause mortality (HR 1.75) compared to a low score in patients with acute decompensated heart failure.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: