Key result
A simple prognostic index based on age, heart rate, systolic blood pressure, and creatinine independently predicted in-hospital mortality in acute heart failure (AUC=0.74, P<0.0001).
Why the study?
Most existing indexes and scores to predict outcome and guide triage in patients hospitalized for heart failure are complex and unfit for bedside use.
Does a simple prognostic index predict in-hospital mortality in patients admitted for acute heart failure?
Observational (n=1,628)
Yes
Does a simple prognostic index predict in-hospital mortality in patients admitted for acute heart failure?
Effect estimate: AUC 0.74
p-value: p=<0.0001
A simple bedside prognostic index using age, heart rate, systolic blood pressure, and creatinine independently predicts in-hospital mortality in acute heart failure.
May aid bedside triage in acute HF; leaves open prospective validation against existing scores.
BACKGROUND: Rapid effective triage is integral to emergency care in patients hospitalized for heart failure, to guide the type and intensity of therapy. Several indexes and scores have been proposed to predict outcome; most of the them are complex and unfit to use at the bedside. METHODS: We propose a new prognostic index for in hospital mortality in acute heart failure. The index is calculated using the following formula: 220 - age - heart rate + systolic blood pressure - (creatinine ×10). The index was tested in 1628 patients admitted for acute heart failure and enrolled, from November 2007 to December 2009, in the Italian Registry on Heart Failure Outcome (IN-HF); a prospective, multicenter, observational study. RESULTS: The prognostic index was an independent predictor for in hospital mortality risk (AUC=0.74, P<0.0001), together with left ventricular ejection fraction (P=0.001), glycemia (P=0.019) and hemoglobin concentration (P=0.002). CONCLUSIONS: A simple prognostic index based on variables easily assessed can be useful to predict mortality in acute heart failure at the first arrival in hospital. The new index is independent from the left ventricular ejection fraction.
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Antonini et al. (2019) conducted an observational in Acute heart failure (n=1,628). Prognostic index (220 - age - heart rate + systolic blood pressure - (creatinine ×10)) was evaluated on In-hospital mortality (AUC 0.74, p=<0.0001). A simple prognostic index based on age, heart rate, systolic blood pressure, and creatinine independently predicted in-hospital mortality in acute heart failure (AUC=0.74, P<0.0001).
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