title: Discharge risk scoring method for predicting mortality in hospitalized chronic heart failure patients with severe systolic dysfunction.
abstract: OBJECTIVE
  Prognostic risk stratification in heart failure is crucial to guide clinical decision-making.The aim of our study was to develop a prognostic discharge risk score model to predict all-cause mortality for chronic heart failure patients with multiple co-morbidities and severe systolic dysfunction.
  
  
  RESULTS
  A multivariable logistic regression model was developed with the use of data on clinical, laboratory, imaging and therapeutic findings of 630 patients with advanced systolic heart failure. A risk score model was developed based on multiplying the beta-coefficient number of each variable in the multivariable model. The model performance was evaluated by concordance index and internally validated by the bootstrapping method. 313 patients (49.7%) of the cohort died during a median follow-up duration of 54 months. Median age was 66 years, 37% were female, 26% had atrial fibrillation and 40% had diabetes mellitus. The mean left ventricular ejection fraction (EF) was 25 +/- 10% and 264 patients (42%) had left ventricular EF < or = 20%. Independent predictors of mortality were older than 70 years, orthopnoea, previous hospitalisations, lack of renin-angiotensin system inhibitor therapy at discharge, hyperuricaemia (>7 mg/dl) and haemoglobin level (<10 g/dL). Discharge risk score identified low-, intermediate- and high-risk individuals with 18%, 40% and 52% mortality rates, respectively. The risk score had a discrimination ability with a concordance index of 0.70.
  
  
  CONCLUSIONS
  In a large heart failure cohort, including patients with severe systolic dysfunction and having multiple comorbidities, a simple discharge risk score with non-invasive and easy-to-obtain variables during hospital admission represents a valuable tool for risk assessment.
authors.forename: Alptug
authors.initials: A
authors.lastname: Tokatli
authors.forename: Kurtulus
authors.initials: K
authors.lastname: Karauzum
authors.forename: Dilek
authors.initials: D
authors.lastname: Ural
authors.forename: Canan
authors.initials: C
authors.lastname: Baydemir
authors.forename: Guliz
authors.initials: G
authors.lastname: Kozdag
authors.forename: Umut
authors.initials: U
authors.lastname: Celikyurt
authors.forename: Yasar
authors.initials: Y
authors.lastname: Akay
authors.forename: Onur
authors.initials: O
authors.lastname: Argan
authors.forename: Irem
authors.initials: I
authors.lastname: Yilmaz
authors.forename: Ahmet
authors.initials: A
authors.lastname: Vural
mesh_terms: D000368:Aged; D015897:Comorbidity; D005260:Female; D054143:Heart Failure, Systolic / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009026:Mortality; D010351:Patient Discharge; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012720:Severity of Illness Index; D013318:Stroke Volume; D014421:Turkey / Q000453:epidemiology; D016277:Ventricular Function, Left