A simple score for early risk stratification in acute heart failure

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• 作者：A. Xanthopoulos^a ; G. Giamouzis^a ; K. Tryposkiadis^b ; E. Paraskevopoulou^c ; P. Paraskevopoulou^d ; G. Karagiannis^e ; S. Patsilinakos^c ; J. Parissis^f ; D. Farmakis^f ; J. Butler^g ; J. Skoularigis^a ; F. Triposkiadis^a ; ^{ftriposkiadis@gmail.com}
• 关键词：Acute heart failure ; Score ; Risk stratification
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：1 March 2017
• 年：2017
• 卷：230
• 期：Complete
• 页码：248-254
• 全文大小：638 K
• 卷排序：230

文摘

The use of many acute heart failure (AHF) risk scores is cumbersome. We therefore developed a simple AHF risk score (AHFRS) for early risk stratification.MethodsThe study consisted of a prospective derivation cohort (PDC; N = 104; age, 77[21] years; LVEF (%), 35[29]) and a retrospective validation cohort (RVC; N = 141; age, 76[15] years; LVEF (%), 35[25]). Clinical, echocardiography and laboratory assessment was performed at admission. The study end-point was death from any cause or HF-rehospitalization at 1 year.ResultsIn the PDC 46 (44.2%) patients experienced the end-point. Independent prognostic factors of outcome were hypertension (HTN) history, myocardial infarction (MI) history, and admission red cell distribution width (RDW). Multivariate logistic regression indicated 8-, 4-, and 3-times higher odds ratio for development of study end-point in patients without a HTN history, with MI history, and RDW ≥ 15% (median) respectively. Thus in AHFRS, 2 points were assigned for absence of HTN history, 1 point for presence of MI history, and 1 point for RDW values ≥ 15% (0 best possible, whereas 4 worst possible score). The AHFRS identified patients who developed the end-point in the PDC with an area under the ROC curve (AUC) of 0.80 [95% C.I.: (0.71, 0.87)] denoting a high discriminative ability. These findings were confirmed in the RVC, in which the endpoint occurred in 52 (36.9%) patients and the AUC for the AHFRS was 0.82 [95% C.I.: (0.73, 0.89)].ConclusionsAHFRS is easily obtained at admission and accurately risk stratifies AHF patients.