Abstract 3175: A Simple Risk Score derived from Euro Heart Failure Survey to Predict Mortality in Acute Heart Failure
Background: Heart failure causes about 5% of medical admissions amongst adults and complicates a further 10–15%. Heart failure has a poor prognosis as one third or more of patients will die within 6 months of diagnosis.
Aim: To derive a simple risk score that can identify patients who are at high risk of death, when hospitalised with acute heart failure.
Methods: The EuroHeart Failure survey collected data from 10,701 patients with suspected heart failure in 115 hospitals from 24 countries across Europe during 2000–2001. Patients had various investigations including a 12 lead ECG, echocardiogram and routine blood tests. We examined all the available clinical variables affecting the 12 week mortality by univariate and multivariable analysis with logistic regression. A risk score to predict mortality in acute heart failure was derived from approximation of the odds ratios obtained from the multi variable model.
Results: A total of 1425 (12.5%) patients died between admission and 12 weeks follow up. On multivariable analysis the following were independently associated with death within 12 weeks: age, severity of left ventricular systolic dysfunction (LVSD), hyponatraemia, renal impairment and absence of treatment with ACE inhibitor or beta blocker. A risk score (0 -12) was calculated as follows: age: < 70 = 0, 71–75 = 1; 76 − 80 = 2 and > 80 = 3, LVSD on echo: mild = 1; moderate = 2 and severe = 3, no BB = 2, no ACEI = 2, hyponatraemia = 1 and renal impairment = 1. A risk score of above 5 was associated with steep increase in mortality (figure⇓).
Conclusions: A risk score using age, LVSD, hyponatraemia, renal impairment and treatment with beta blocker and ACEI can predict mortality in acute heart failure.