A Simple Clinically Based Predictive Rule for Heart Failure In-Hospital Mortality
Scarce data are available to predict in-hospital mortality for decompensated heart failure (HF) in South American populations. We evaluated 779 consecutive HF admissions defined by the Boston criteria in a tertiary care hospital. Stepwise logistic regression was used to determine independent correla...
Gespeichert in:
Veröffentlicht in: | Journal of cardiac failure 2006-10, Vol.12 (8), p.587-593 |
---|---|
Hauptverfasser: | , , , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
Zusammenfassung: | Scarce data are available to predict in-hospital mortality for decompensated heart failure (HF) in South American populations.
We evaluated 779 consecutive HF admissions defined by the Boston criteria in a tertiary care hospital. Stepwise logistic regression was used to determine independent correlates of in-hospital mortality, derived from 83 potential predictors collected on hospital admission. A clinical score rule (HF Revised Score) was created using the regression coefficient estimates derived from multivariate modeling. During hospital stay, 77 (10%) deaths occurred and 6 clinical characteristics were independently associated with in-hospital mortality: presence of cancer (
P < .001), systolic blood pressure ≤124 mm Hg (
P < .001), serum creatinine >1.4 mg/dL (
P = .02), blood urea nitrogen >37 mg/dL (
P = .03), serum sodium 70 years old (
P = .03). Both the Acute Decompensated Heart Failure National Registry stratification algorithm and the proposed HF Revised Score performed adequately to predict in-hospital mortality (“c” statistics = 0.71 and 0.76, respectively). The newly proposed score, however, discriminated a very low-risk group (101 [13%]) in whom all patients were discharged home, representing patients admitted with none of the 6 predictors of risk.
HF risk stratification can be accurately accomplished during the first day of admission with simple and easily obtained clinical variables. |
---|---|
ISSN: | 1071-9164 1532-8414 |
DOI: | 10.1016/j.cardfail.2006.06.475 |