title: A simple score for early risk stratification in acute heart failure.
abstract: BACKGROUND
  The use of many acute heart failure (AHF) risk scores is cumbersome. We therefore developed a simple AHF risk score (AHFRS) for early risk stratification.
  
  
  METHODS
  The study consisted of a prospective derivation cohort (PDC; N=104; age, 77[21] years; LVEF (%), 35[29]) and a retrospective validation cohort (RVC; N=141; age, 76[15] years; LVEF (%), 35[25]). Clinical, echocardiography and laboratory assessment was performed at admission. The study end-point was death from any cause or HF-rehospitalization at 1year.
  
  
  RESULTS
  In the PDC 46 (44.2%) patients experienced the end-point. Independent prognostic factors of outcome were hypertension (HTN) history, myocardial infarction (MI) history, and admission red cell distribution width (RDW). Multivariate logistic regression indicated 8-, 4-, and 3-times higher odds ratio for development of study end-point in patients without a HTN history, with MI history, and RDW≥15% (median) respectively. Thus in AHFRS, 2 points were assigned for absence of HTN history, 1 point for presence of MI history, and 1 point for RDW values ≥15% (0 best possible, whereas 4 worst possible score). The AHFRS identified patients who developed the end-point in the PDC with an area under the ROC curve (AUC) of 0.80 [95% C.I.: (0.71, 0.87)] denoting a high discriminative ability. These findings were confirmed in the RVC, in which the endpoint occurred in 52 (36.9%) patients and the AUC for the AHFRS was 0.82 [95% C.I.: (0.73, 0.89)].
  
  
  CONCLUSIONS
  AHFRS is easily obtained at admission and accurately risk stratifies AHF patients.
authors.affiliation: University General Hospital of Larissa, Department of Cardiology, Larissa, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Xanthopoulos
authors.affiliation: University General Hospital of Larissa, Department of Cardiology, Larissa, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Giamouzis
authors.affiliation: Independent Biostatistician, Athens, Greece.
authors.forename: K
authors.initials: K
authors.lastname: Tryposkiadis
authors.affiliation: Konstantopoulio General Hospital, Cardiology Department, Athens, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Paraskevopoulou
authors.affiliation: Konstantopoulio General Hospital, Hematology Lab, Athens, Greece.
authors.forename: P
authors.initials: P
authors.lastname: Paraskevopoulou
authors.affiliation: Harefield Hospital, London, United Kingdom.
authors.forename: G
authors.initials: G
authors.lastname: Karagiannis
authors.affiliation: Konstantopoulio General Hospital, Cardiology Department, Athens, Greece.
authors.forename: S
authors.initials: S
authors.lastname: Patsilinakos
authors.affiliation: Department of Cardiology, Athens University Hospital Attikon, Athens, Greece.
authors.forename: J
authors.initials: J
authors.lastname: Parissis
authors.affiliation: Department of Cardiology, Athens University Hospital Attikon, Athens, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Farmakis
authors.affiliation: Division of Cardiology, Stony Brook University, Stony Brook, New York, United States.
authors.forename: J
authors.initials: J
authors.lastname: Butler
authors.affiliation: University General Hospital of Larissa, Department of Cardiology, Larissa, Greece.
authors.forename: J
authors.initials: J
authors.lastname: Skoularigis
authors.affiliation: University General Hospital of Larissa, Department of Cardiology, Larissa, Greece. Electronic address: ftriposkiadis@gmail.com.
authors.forename: F
authors.initials: F
authors.lastname: Triposkiadis
mesh_terms: D000208:Acute Disease; D000368:Aged; D005260:Female; D006115:Greece / Q000453:epidemiology; D006333:Heart Failure / Q000453:epidemiology*; D006801:Humans; D008297:Male; D009017:Morbidity / Q000639:trends; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D015996:Survival Rate / Q000639:trends
keywords: Acute heart failure; Risk stratification; Score