title: AHEAD score--Long-term risk classification in acute heart failure.
abstract: BACKGROUND
  The role of co-morbidities in the prognosis of patients hospitalized for AHF was examined using the AHEAD (A--atrial fibrillation, H--haemoglobin<130 g/l for men and 120 g/l for women (anaemia), E--elderly (age>70years), A--abnormal renal parameters (creatinine>130 μmol/l), D--diabetes mellitus) scoring system.
  
  
  METHODS
  AHEAD--multicentre prospective Czech registry of AHF patients; GREAT registry--international cohort of AHF patients. Data from 5846 consecutive patients hospitalized for AHF (AHEAD registry; derivation cohort) were analysed to build the AHEAD score. Each risk factor of the AHEAD score was counted as 1 point. The model was validated externally using an international cohort of similar patients in the GREAT registry (6315).
  
  
  RESULTS
  Main outcome was one year all-cause mortality. The mean age of patients was 72±12 years, with 61.6% of patients aged >70 years; 43.4% were women. Atrial fibrillation was present in 30.7%, anaemia in 38.2%, creatinine>130 mmol/l (abnormal renal parameters) in 30.1%, and diabetes mellitus in 44.0%. The mean AHEAD score was 2.1. In patients with AHEAD scores of 0-5, the one-year mortality rates were 13.6%, 23.4%, 32.0%, 41.1%, 47.7%, and 58.2%, respectively (p<0.001), and the 90 month mortality rates were 35.1%, 57.3%, 73.5%, 84.8%, 88.0%, and 91.7%, respectively (p<0.001).
  
  
  CONCLUSIONS
  The AHEAD is a simple scoring system based on the analysis of co-morbidities for the estimation of the short and long term prognosis of patients hospitalized for AHF.
authors.affiliation: Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Medical Faculty, Masaryk University, Brno, Czech Republic; Department of Cardiovascular Disease, International Clinical Research Center, University Hospital St Anne's, Brno, Czech Republic.
authors.forename: Jindrich
authors.initials: J
authors.lastname: Spinar
authors.affiliation: Institute of Biostatistics and Analysis, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Jarkovsky
authors.affiliation: Medical Faculty, Masaryk University, Brno, Czech Republic; First Department of Cardiovascular Internal Medicine, University Hospital St Anne's, Brno, Czech Republic.
authors.forename: Lenka
authors.initials: L
authors.lastname: Spinarova
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Saint Louis Lariboisiere University Hospital, Paris, France; UMR-S 942, Inserm, Paris, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Mebazaa
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Saint Louis Lariboisiere University Hospital, Paris, France; UMR-S 942, Inserm, Paris, France.
authors.forename: Etienne
authors.initials: E
authors.lastname: Gayat
authors.affiliation: Medical Faculty, Masaryk University, Brno, Czech Republic; First Department of Cardiovascular Internal Medicine, University Hospital St Anne's, Brno, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Vitovec
authors.affiliation: 2nd Department of Cardiovascular Internal Medicine, First Medical Faculty, Charles University, Prague and General Teaching Hospital of Prague, Prague, Czech Republic.
authors.forename: Ales
authors.initials: A
authors.lastname: Linhart
authors.affiliation: Kralovske Vinohrady University Hospital and the 3rd Faculty of Medicine, Charles University, Prague, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Widimsky
authors.affiliation: Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Department of Cardiovascular Disease, International Clinical Research Center, University Hospital St Anne's, Brno, Czech Republic.
authors.forename: Roman
authors.initials: R
authors.lastname: Miklik
authors.affiliation: Department of Internal Medicine, Hospital Frydek-Mistek, Frydek-Mistek, Czech Republic.
authors.forename: Kamil
authors.initials: K
authors.lastname: Zeman
authors.affiliation: 2nd Department of Cardiovascular Internal Medicine, First Medical Faculty, Charles University, Prague and General Teaching Hospital of Prague, Prague, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Belohlavek
authors.affiliation: Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic.
authors.forename: Filip
authors.initials: F
authors.lastname: Malek
authors.affiliation: Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Medical Faculty, Masaryk University, Brno, Czech Republic; Department of Cardiovascular Disease, International Clinical Research Center, University Hospital St Anne's, Brno, Czech Republic.
authors.forename: Marian
authors.initials: M
authors.lastname: Felsoci
authors.affiliation: Department of Cardiology, Institute of Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Kettner
authors.affiliation: Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Ostadal
authors.affiliation: Department of Internal Medicine, University Hospital Olomouc, Olomouc, Czech Republic.
authors.forename: Cestmir
authors.initials: C
authors.lastname: Cihalik
authors.affiliation: Department of Internal Medicine, University Hospital Olomouc, Olomouc, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Vaclavik
authors.affiliation: Department of Internal Medicine, University Hospital Olomouc, Olomouc, Czech Republic.
authors.forename: Miloš
authors.initials: M
authors.lastname: Taborsky
authors.affiliation: Institute of Biostatistics and Analysis, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Ladislav
authors.initials: L
authors.lastname: Dusek
authors.affiliation: Institute of Biostatistics and Analysis, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Simona
authors.initials: S
authors.lastname: Littnerova
authors.affiliation: Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Medical Faculty, Masaryk University, Brno, Czech Republic; Department of Cardiovascular Disease, International Clinical Research Center, University Hospital St Anne's, Brno, Czech Republic. Electronic address: jiri.parenica@atlas.cz.
authors.forename: Jiri
authors.initials: J
authors.lastname: Parenica
mesh_terms: D000208:Acute Disease; D000368:Aged; D006328:Cardiac Catheterization; D002423:Cause of Death / Q000639:trends; D018153:Czech Republic / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
keywords: Acute heart failure; Model; Mortality; Prognosis