Predicting short-term mortality in advanced decompensated heart failure - role of the updated acute decompensated heart failure/N-terminal pro-B-type natriuretic Peptide risk score

Circulation Journal : Official Journal of the Japanese Circulation Society
Domenico ScrutinioMaria Frigerio

Abstract

The first few months after admission are the most vulnerable period in patients with acute decompensated heart failure (ADHF). We assessed the association of the updated ADHF/N-terminal pro-B-type natriuretic peptide (NT-proBNP) risk score with 90-day and in-hospital mortality in 701 patients admitted with advanced ADHF, defined as severe symptoms of worsening HF, severely depressed left ventricular ejection fraction, and the need for i.v. diuretic and/or inotropic drugs. A total of 15.7% of the patients died within 90 days of admission and 5.2% underwent ventricular assist device (VAD) implantation or urgent heart transplantation (UHT). The C-statistic of the ADHF/NT-proBNP risk score for 90-day mortality was 0.810 (95% CI: 0.769-0.852). Predicted and observed mortality rates were in close agreement. When the composite outcome of death/VAD/UHT at 90 days was considered, the C-statistic decreased to 0.741. During hospitalization, 7.6% of the patients died. The C-statistic for in-hospital mortality was 0.815 (95% CI: 0.761-0.868) and Hosmer-Lemeshow χ(2)=3.71 (P=0.716). The updated ADHF/NT-proBNP risk score outperformed the Acute Decompensated Heart Failure National Registry, the Organized Program to Initiate Lifesaving Treatmen...Continue Reading

References

Jul 31, 1998·The New England Journal of Medicine·E R LevinW K Samson
Nov 20, 2003·JAMA : the Journal of the American Medical Association·Douglas S LeeJack V Tu
Mar 12, 2004·Journal of the American College of Cardiology·Jayant NathPaul A Heidenreich
Feb 3, 2005·JAMA : the Journal of the American Medical Association·Gregg C FonarowUNKNOWN ADHERE Scientific Advisory Committee, Study Group, and Investigators
Dec 21, 2005·Circulation·Mihai GheorghiadeUNKNOWN International Working Group on Acute Heart Failure Syndromes
Oct 19, 2006·Journal of Cardiac Failure·Luis E RohdeNadine Clausell
Sep 16, 2008·International Journal of Cardiology·Periaswamy VelavanJohn G F Cleland
Nov 26, 2008·Archives of Internal Medicine·Kevin McGeechanTien Y Wong
Feb 14, 2009·Journal of the American College of Cardiology·Mihai Gheorghiade, Peter S Pang
Feb 4, 2010·Circulation. Cardiovascular Quality and Outcomes·Pamela N PetersonUNKNOWN American Heart Association Get With the Guidelines-Heart Failure Program
Sep 13, 2011·Congestive Heart Failure·Eric S Ketchum, Wayne C Levy
Nov 29, 2012·European Journal of Heart Failure·Damien LogeartUNKNOWN Heart Failure of the French Society of Cardiology
Feb 9, 2013·PLoS Medicine·Ewout W SteyerbergUNKNOWN PROGRESS Group
Jun 8, 2013·Journal of Cardiac Failure·Michael M GivertzRandall C Starling
Jun 12, 2013·Journal of the American College of Cardiology·Clyde W YancyUNKNOWN American Heart Association Task Force on Practice Guidelines
Jul 28, 2013·Circulation. Heart Failure·Ana C AlbaHeather J Ross
Dec 10, 2013·Circulation Journal : Official Journal of the Japanese Circulation Society·Yasuhiko SakataHiroaki Shimokawa
Feb 4, 2014·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Domenico ScrutinioFabrizio Oliva
Feb 7, 2014·Circulation Journal : Official Journal of the Japanese Circulation Society·Shinsuke HanataniHisao Ogawa
Feb 26, 2014·The Canadian Journal of Cardiology·Douglas S Lee, Justin A Ezekowitz
Mar 20, 2014·European Journal of Internal Medicine·Enrico AmmiratiMaria Frigerio
Aug 30, 2014·Circulation Journal : Official Journal of the Japanese Circulation Society·Domenico ScrutinioFabrizio Oliva

❮ Previous
Next ❯

Related Concepts

Related Feeds

Artificial Heart & Ventricular Assist Devices

Total artificial hearts (TAH) and ventricular assist devices (VADs) provide cardiac support for patients with end-stage heart disease and have significantly improved the survival of these patients. Discover the latest research on Artificial Heart and Ventricular Assist Devices here.