Key result
A PROFUND score ≥ 7 was associated with significantly higher 30-day mortality compared to a score < 7 (33% vs 15%, p=0.03) in elderly patients admitted for acute heart failure.
Why the study?
Heart failure patients increasingly have complex comorbidities, and the prognostic value of the PROFUND index—developed for pluripathology patients—had not been evaluated for short-term mortality in acute heart failure.
Does the PROFUND index predict in-hospital and 30-day mortality in patients admitted with acute heart failure and multiple comorbidities?
Cohort (n=128)
Yes
Does the PROFUND index predict in-hospital and 30-day mortality in patients admitted with acute heart failure and multiple comorbidities?
The PROFUND index may be a useful clinical tool for predicting short-term mortality in elderly patients with acute heart failure and multiple comorbidities.
PROFUND index may aid short-term risk stratification in elderly AHF; leaves open its clinical utility pending larger prospective validation.
Background and Objectives: The prevalence and incidence of heart failure (HF) have been increasing in recent years as the population ages. These patients show a distinct profile of comorbidity, which makes their care more complex. In recent years, the PROFUND index, a specific tool for estimating the mortality rate at one year in pluripathology patients, has been developed. The aim of this study was to evaluate the prognostic value of the PROFUND index and of in-hospital and 30-day mortality after discharge of patients admitted for acute heart failure (AHF). Materials and Methods: A prospective multicenter longitudinal study was performed that included patients admitted with AHF and ≥2 comorbid conditions. Clinical, analytical, and prognostic variables were collected. The PROFUND index was collected in all patients and rates of in-hospital and 30-day mortality after discharge were analyzed. A bivariate analysis was performed with quantitative variables between patients who died and those who survived at the 30-day follow-up. A logistic regression analysis was performed with the variables that obtained statistical significance in the bivariate analysis between deceased and surviving subjects. Results: A total of 128 patients were included. Mean age was 80.5 +/− 9.98 years, and women represented 51.6%. The mean PROFUND index was 5.26 +/− 4.5. The mortality rate was 8.6% in-hospital and 20.3% at 30 days. Preserved left ventricular ejection fraction was found in 60.9%. In the sample studied, there were patients with a PROFUND score < 7 predominated (89 patients (70%) versus 39 patients (31%) with a PROFUND score ≥ 7). Thirteen patients (15%) with a PROFUND score < 7 died versus the 13 (33%) with a PROFUND score ≥ 7, p = 0.03. Twelve patients (15%) with a PROFUND score < 7 required readmission versus 12 patients (35%) with a PROFUND score ≥ 7, p = 0.02. The ROC curve of the PROFUND index for in-hospital mortality and 30-day follow-up in patients with AHF showed AUC 0.63, CI: 95% (0.508–0.764), p <0.033. Conclusions: The PROFUND index is a clinical tool that may be useful for predicting short-term mortality in elderly patients with AHF. Further studies with larger simple sizes are required to validate these results.
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Méndez‐Bailón et al. (2021) conducted a cohort in Acute heart failure with ≥2 comorbid conditions (n=128). PROFUND score ≥ 7 vs. PROFUND score < 7 was evaluated on 30-day mortality (p=0.03). A PROFUND score ≥ 7 was associated with significantly higher 30-day mortality compared to a score < 7 (33% vs 15%, p=0.03) in elderly patients admitted for acute heart failure.
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