Highlights
- •First episodes and decompensation of chronic heart failure have different prognosis.
- •A score is presented to assess prognosis after the first episode of heart failure.
- •This score needs to be validated in an external cohort prior to implementation.
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.
Keywords
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Article info
Publication history
Published online: March 04, 2020
Accepted:
February 14,
2020
Received in revised form:
February 12,
2020
Received:
September 9,
2019
Risk score for de-novo heart failureFootnotes
ClinicalTrials.gov ID: NCT03512704.
Identification
Copyright
© 2020 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
