Death Risk of Heart Failure Patients

A new practical tool has been developed to predict the high, intermediate, and low risk of death in hospitalized heart failure patients, using two simple blood tests and a single blood pressure measurement.

Investigators used a type of statistical analysis known as CART (classification and regression tree) to analyze a number of clinical variables in order to develop a tool to assess mortality risk in heart failure patients. From an observational evaluation of 39 clinical variables from more than 65,000 hospitalized heart failure patients, they were able to define three clinical characteristics that put patients at greatest risk of mortality. These are high levels of blood urea nitrogen (BUN greater or equal to mg/dl), low systolic blood pressure (SBP > 115 mm HG), and high serum creatinine (Cr greater than or equal to 2.75 mg/dl). The validity of this tool was tested using data from an additional 32,229 hospitalizations.

The overall mortality risk for patients hospitalized with acute heart failure was 4.1%. The new tool determined mortality risk levels starting from low risk at 2.1% up to 21.9% for patients with the highest risk. Clyde W. Yancy, M.D., professor of medicine and cardiology at the University of Texas Southwestern Medical Center (Dallas, USA; www.swmed.edu) was a contributing investigator of the study.

"This new tool is a first for the treatment of acute decompensated heart failure, and offers a simple quick way for clinicians to assess mortality risk upon hospital admission and rapidly decide on a treatment strategy,” noted Gregg C. Fonarow, M.D., professor of medicine in the division of cardiology at the University of California, Los Angeles (USA).

The study was conducted by investigators from the world's largest heart failure registry, known as ADHERE (acute decompensated heart failure), sponsored by Scios, Inc. (San Francisco, CA, USA). The study was published in the February 2, 2005, issue of the Journal of the American Medical Association.