Key result
High admission EASIX score is linked to ~2.8-fold higher odds of 30-day mortality.
Why the study?
The EASIX score is a validated biomarker of endothelial stress in other clinical settings, but its utility in predicting short-term outcomes specifically in acute heart failure is not well-defined.
Does a higher admission EASIX score predict 30-day all-cause mortality and readmission rates in patients hospitalized for heart failure?
Cohort (n=6,832)
No
Does a higher admission EASIX score predict 30-day all-cause mortality and readmission rates in patients hospitalized for heart failure?
An elevated admission EASIX score (>4.40) is an independent predictor of 30-day mortality and readmission in patients hospitalized for heart failure, offering a simple tool for early risk stratification.
High admission EASIX was associated with elevated 30-day mortality and readmission in acute HF; supports validation as a stratification tool in prospective studies.
Background Heart failure (HF) is a major cause of mortality and morbidity, with early post-discharge readmission serving as a critical indicator of poor prognosis and high healthcare burden. Endothelial dysfunction plays a central role in HF progression and organ damage. The EASIX score (LDH X Creatinine / Platelets) is a simple, validated biomarker of endothelial stress. While its prognostic value is established in other clinical settings, its utility in predicting short-term outcomes specifically in acute HF is not well-defined. Purpose To investigate the ability of admission EASIX score for predicting 30-day all-cause mortality and readmissions in a large cohort of hospitalized HF patients. Methods We analyzed 6,832 patients hospitalized for HF at a tertiary center (2010–2020). EASIX was calculated within 24 hours of admission. Patients were stratified into quartiles (Q1: <1.80, Q2: 1.80–2.73, Q3: 2.74–4.39, Q4: >4.40). Primary outcomes were 30-day mortality and readmission rates. Results The study population had a mean age of 76.5± 12.1 years, (55% male, 38% with reduced systolic function). Elevated EASIX scores demonstrated a strong, independent association with adverse outcomes:30- Day Mortality Rates: Increased progressively from 7.5% in the lowest quartile (Q1) to 19.9% in the highest quartile (Q4) (p < 0.001).30- Day Readmission: Patients in Q4 had a significantly higher readmission compared to Q1 (Q4: 23.8% vs. Q1: 19.6%; p = 0.012).Multivariable Analysis: After adjusting for clinical variables (including Hb, CRP, WBC, Gender, HTN and lipids), the highest EASIX quartile (Q4) remained a robust independent predictor for both outcomes:30-Day Mortality: Adjusted Odds Ratio (OR) of 2.75 (95% CI 2.22–3.39, p < 0.001).30-Day Readmission: Adjusted Odds Ratio (OR) of 1.29 (95% CI 1.10-1.50, p = 0.001). Conclusion The EASIX score is a simple, cost-effective, and readily available tool for early risk stratification in HF. High EASIX scores at admission identify patients at increased risk for early post-discharge mortality and readmission, potentially guiding more intensive follow-up and management strategies.
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Eliger et al. (2026) conducted a cohort in Acute heart failure (n=6,832). Highest admission EASIX quartile (Q4: >4.40) vs. Lowest admission EASIX quartile (Q1: <1.80) was evaluated on 30-day all-cause mortality and 30-day readmission rates (OR 2.75, 95% CI 2.22-3.39, p=<0.001). High admission EASIX score (Q4 vs Q1) independently predicted 30-day mortality (19.9% vs 7.5%; aOR 2.75, 95% CI 2.22-3.39) and readmission (23.8% vs 19.6%; aOR 1.29, 95% CI 1.10-1.50).
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