Acute Heart Failure Mortality Predicted by Emergency Department Risk Score

HealthDay News — For patients with acute heart failure (AHF) admitted to the emergency department (ED), a risk score based on 13 independent risk factors can predict 30-day mortality, according to a study published in the Annals of Internal Medicine.

Òscar Miró, PhD, from the University of Barcelona in Spain, and colleagues conducted a prospective cohort study in 34 Spanish EDs to predict mortality using data that are readily available at ED admission. The derivation and validation cohorts included 4867 ED patients admitted during 2009 to 2011 and 3229 ED patients admitted during 2014, respectively.

The researchers identified 13 independent risk factors in the derivation cohort, which were combined into an overall score (Multiple Estimation of risk based on the Emergency department Spanish Score in patients with AHF). 

Thirty-day mortality was predicted by the score with excellent discrimination (C-statistic, 0.836) and calibration (Hosmer-Lemeshow P =.99); across risk groups the score provided a steep gradient in 30-day mortality (<2% for patients in 2 lowest-risk quintiles and 45% in highest-risk decile). In the validation cohort these findings were confirmed (C-statistic, 0.828).

“Physicians can consider using this tool to inform clinical decisions as further studies are done to determine whether the tool enhances physician decision making and improves patient outcomes,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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Miro O, Rossello X, Gil V, et al. Predicting 30-day mortality for patients with acute heart failure in the emergency department: a cohort study [published online October 3, 2017]. Ann Intern Med. doi: 10.7326/M16-2726