Susana García-Gutiérrez1, Ane Antón-Ladislao2, Raul Quiros3, Antonio Lara4, Irene Rilo5, Miren Morillas6, Nekane Murga7, Maria Soledad Gallardo8, Iratxe Lafuente2, Urko Aguirre2, Jose Maria Quintana2. 1. Unidad de Investigación, Hospital Galdakao-Usansolo [Osakidetza] - Red de Investigación en Servicios de Salud en Enfermedades Crónicas [REDISSEC], Galdakao, Bizkaia, Spain. Electronic address: susana.garciagutierrez@osakidetza.net. 2. Unidad de Investigación, Hospital Galdakao-Usansolo [Osakidetza] - Red de Investigación en Servicios de Salud en Enfermedades Crónicas [REDISSEC], Galdakao, Bizkaia, Spain. 3. Hospital Costa del Sol, Internal Medicine Department Andalucía- Red de Investigación en Servicios de Salud en Enfermedades Crónicas [REDISSEC], Marbella, Malaga, Spain. 4. Hospital Universitario de Canarias; Cardiology Department, Islas Canarias-- Red de Investigación en Servicios de Salud en Enfermedades Crónicas [REDISSEC], Tenerife, Islas Canarias, Spain. 5. Hospital Universitario de Donostia, Cardiology Department, Donostia, Gipuzkoa, Spain. 6. Hospital Galdakao-Usansolo, Cardiology Departament, Galdakao, Bizkaia, Spain. 7. Hospital Universitario Basurto, Cardiology Department, Bilbao, Bizkaia, Spain. 8. Hospital Galdakao-Usansolo, Emergency Department, Galdakao. Bizkaia, Spain.
Abstract
BACKGROUND: Different variables are playing a role in prognosis of acute heart failure. OBJECTIVES: Our purpose was to create and validate a risk score to predict mortality in patients with a first episode of acute heart failure during the first 2 months after the first hospitalization. DESIGN: This was a prospective cohort study. PARTICIPANTS: We recruited patients diagnosed with a first episode of acute heart failure. MAIN MEASURES: We collected data on sociodemographic characteristics; medical history; symptoms; precipitating factors; signs and symptoms of congestion; echocardiographic parameters; aetiology; vital signs and laboratory findings; and response to initial treatment (yes/no). A Cox proportional hazard regression model was built with mortality during the first 2 months after the index episode as the dependent variable. A risk score is presented. KEY RESULTS: The mortality rate during the first 2 months after a first episode of heart failure was 5%. Age, systolic blood pressure, serum sodium, ejection fraction and blood urea nitrogen were selected in the internal validation, as was right ventricular failure. A risk score was developed. Both the model and the score showed good discrimination and calibration properties when applied to an independent cohort. CONCLUSIONS: Our ESSIC-FEHF risk score showed excellent properties in the derivation cohort and also in a cohort from a different time period. This score is expected to help decision making in patients diagnosed with heart failure for the first time.
BACKGROUND: Different variables are playing a role in prognosis of acute heart failure. OBJECTIVES: Our purpose was to create and validate a risk score to predict mortality in patients with a first episode of acute heart failure during the first 2 months after the first hospitalization. DESIGN: This was a prospective cohort study. PARTICIPANTS: We recruited patients diagnosed with a first episode of acute heart failure. MAIN MEASURES: We collected data on sociodemographic characteristics; medical history; symptoms; precipitating factors; signs and symptoms of congestion; echocardiographic parameters; aetiology; vital signs and laboratory findings; and response to initial treatment (yes/no). A Cox proportional hazard regression model was built with mortality during the first 2 months after the index episode as the dependent variable. A risk score is presented. KEY RESULTS: The mortality rate during the first 2 months after a first episode of heart failure was 5%. Age, systolic blood pressure, serum sodium, ejection fraction and blood ureanitrogen were selected in the internal validation, as was right ventricular failure. A risk score was developed. Both the model and the score showed good discrimination and calibration properties when applied to an independent cohort. CONCLUSIONS: Our ESSIC-FEHF risk score showed excellent properties in the derivation cohort and also in a cohort from a different time period. This score is expected to help decision making in patients diagnosed with heart failure for the first time.