A simple risk score to predict in-hospital death of elderly patients with acute decompensated heart failure--hypoalbuminemia as an additional prognostic factor.
BACKGROUND
Risk stratification for elderly patients with acute decompensated heart failure (ADHF) may help clinicians to select the appropriate therapy and raise the quality of care.


RESULTS
The present study enrolled 349 patients aged over 65 years who were hospitalized with ADHF from January 2004 to October 2008. Five independent prognostic factors were identified by multivariate logistic regression analysis, and each factor was assigned a number of points proportional to its regression coefficient: prior heart failure hospitalization (2 points), sodium <or=138 mmol/L (2 points), BUN >or=35 mg/dl (2 points), albumin <or=3.2 g/dl (3 points), and BNP >or=980 pg/ml (2 points); in particular, hypoalbuminemia was identified as the strongest prognostic factor. The patients were stratified into 3 groups: low risk (0-4 points), moderate risk (5-7 points), and high risk (8-11 points). The respective in-hospital mortality rates were 1.6%, 15.8%, and 42.1% (P<0.05).


CONCLUSIONS
In addition to known prognostic factors, hypoalbuminemia may provide important information for elderly patients with ADHF. A simple risk score may help to stratify the risk of in-hospital mortality and contribute to better clinical management of these elderly patients.
Kinugasa
Yoshiharu
Y
Department of Cardiovascular Medicine, Faculty of Medicine, Tottori University, Yonago, Japan. ykinugasa-circ@umin.ac.jp
Kato
Masahiko
M
Sugihara
Shinobu
S
Hirai
Masayuki
M
Kotani
Kazuhiko
K
Ishida
Katsunori
K
Yanagihara
Kiyotaka
K
Kato
Yosuke
Y
Ogino
Kazuhide
K
Igawa
Osamu
O
Hisatome
Ichiro
I
Shigemasa
Chiaki
C
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D034141:Hypoalbuminemia / Q000097:blood / Q000175:diagnosis / Q000401:mortality*; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis*
D015415:Biomarkers; D012709:Serum Albumin