title: Predictors of short term mortality in heart failure - insights from the Euro Heart Failure survey.
abstract: OBJECTIVE
  To identify factors associated with short term mortality in hospitalised patients with heart failure.
  
  
  BACKGROUND
  Hospitalisation is frequent in patients with heart failure and is associated with a high mortality.
  
  
  METHODS
  The Euro Heart Failure survey collected data from patients with suspected heart failure. We searched this data for predictors of short term mortality.
  
  
  RESULTS
  Of 10,701 patients, 1404 (13%) died within 12 weeks of admission. On univariate analysis, increasing age, hyponatraemia, renal impairment, hyperkalaemia, anaemia, severe mitral regurgitation, severe LV systolic dysfunction(LVSD), increasing QRS and female sex carried adverse prognosis. ACEI, beta-blockers, nitrates, anti-thrombotic and lipid lowering drugs were associated with a better prognosis. On multivariable analysis the following provided independent prognostic information: increasing age (OR per SD=1.5, 95% CI 1.4-1.6), severe LVSD (1.8, 1.5-2.1), serum creatinine (1.2, 1.2-1.3), sodium (0.9, 0.8-0.9), Hb (0.9, 0.8-0.9) and treatment with ACEI (0.5, 0.5-0.6), beta-blockers (0.7, 0.6-0.8), statins (0.6, 0.5-0.7), calcium channel blockers (0.7, 0.6-0.8), warfarin (0.5, 0.4-0.6), heparin (1.7, 1.4-1.9), anti-platelet drugs (0.6, 0.5-0.6) and need for inotropes (5.5, 4.6-6.6). A simple risk score (range 0-11) identified cohorts with a 12 week mortality ranging from 2% to 44%.
  
  
  CONCLUSIONS
  Simple and readily available clinical variables and a risk score based on medical history and routine tests that all patients admitted with heart failure have, can identify patients with good, intermediate and high short term mortality.
authors.affiliation: Department of Academic Cardiology, University of Hull, UK. drvelavan@hotmail.com
authors.forename: Periaswamy
authors.initials: P
authors.lastname: Velavan
authors.forename: Nasrin K
authors.initials: NK
authors.lastname: Khan
authors.forename: Kevin
authors.initials: K
authors.lastname: Goode
authors.forename: Alan S
authors.initials: AS
authors.lastname: Rigby
authors.forename: Poay H
authors.initials: PH
authors.lastname: Loh
authors.forename: Michel
authors.initials: M
authors.lastname: Komajda
authors.forename: Ferenc
authors.initials: F
authors.lastname: Follath
authors.forename: Karl
authors.initials: K
authors.lastname: Swedberg
authors.forename: Hugo
authors.initials: H
authors.lastname: Madeira
authors.forename: John G F
authors.initials: JG
authors.lastname: Cleland
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002316:Cardiotonic Agents / Q000627:therapeutic use; D002784:Cholesterol / Q000097:blood; D015897:Comorbidity; D005060:Europe / Q000453:epidemiology; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006306:Health Surveys; D006333:Heart Failure / Q000188:drug therapy / Q000401:mortality*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012307:Risk Factors
chemical_list: D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers; D002316:Cardiotonic Agents; D005343:Fibrinolytic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002784:Cholesterol