Short-term mortality risk score for de novo acute heart failure (ESSIC-FEHF)

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: Emergency medicine; Heart failure; risk assessment.