title: Routine laboratory results and thirty day and one-year mortality risk following hospitalization with acute decompensated heart failure.
abstract: BACKGROUND
  Several blood tests are performed uniformly in patients hospitalized with acute decompensated heart failure and are predictive of the outcomes: complete blood count, electrolytes, renal function, glucose, albumin and uric acid. We sought to evaluate the relationship between routine admission laboratory tests results, patient characteristics and 30-day and one-year mortality of patients admitted for decompensated heart failure and to construct a simple mortality prediction tool.
  
  
  METHODS
  A retrospective population based study. Data from seven tertiary hospitals on all admissions with a principal diagnosis of heart failure during the years 2002-2005 throughout Israel were captured.
  
  
  RESULTS
  8,246 patients were included in the study cohort. Thirty day mortality rate was 8.5% (701 patients) and one-year mortality rate was 28.7% (2,365 patients). Addition of five routine laboratory tests results (albumin, sodium, blood urea, uric acid and WBC) to a set of clinical and demographic characteristics improved c-statistics from 0.76 to 0.81 for 30-days and from 0.72 to 0.76 for one-year mortality prediction (both p-values <0.0001). Three dichotomized abnormal laboratory results with highest odds ratio for one-year mortality (hypoalbuminaemia, hyponatremia and elevated blood urea) were used to construct a simple prediction score, capable of discriminating from 1.1% to 21.4% in 30-day and from 11.6% to 55.6% in one-year mortality rates between patients with a score of 0 (1,477 patients) vs. score of 3 (544 patients).
  
  
  CONCLUSIONS
  A small set of abnormal routine laboratory results upon admission can risk-stratify and independently predict 30-day and one-year mortality in patients hospitalized with acute decompensated heart failure.
authors.affiliation: Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel. VictorNo@clalit.org.il
authors.forename: Victor
authors.initials: V
authors.lastname: Novack
authors.forename: Michael
authors.initials: M
authors.lastname: Pencina
authors.forename: Doron
authors.initials: D
authors.lastname: Zahger
authors.forename: Lior
authors.initials: L
authors.lastname: Fuchs
authors.forename: Roman
authors.initials: R
authors.lastname: Nevzorov
authors.forename: Allan
authors.initials: A
authors.lastname: Jotkowitz
authors.forename: Avi
authors.initials: A
authors.lastname: Porath
mesh_terms: D000368:Aged; D002138:Calibration; D019411:Clinical Laboratory Techniques; D003955:Diagnostic Tests, Routine; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality*; D006760:Hospitalization; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012306:Risk; D013997:Time Factors
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