A simple prognostic index in acute heart failure

BACKGROUND: Rapid effective triage is integral to emergency care in patients hospitalized for heart failure, to guide the type and intensity of therapy. Several indexes and scores have been proposed to predict outcome; most of the them are complex and unfit to use at the bedside. METHODS: We propose a new prognostic index for in hospital mortality in acute heart failure. The index is calculated using the following formula: 220 - age - heart rate + systolic blood pressure - (creatinine x10). The index was tested in 1628 patients admitted for acute heart failure and enrolled, from November 2007 to December 2009, in the Italian Registry on Heart Failure Outcome (IN-HF); a prospective, multicenter, observational study. RESULTS: The prognostic index was an independent predictor for in hospital mortality risk (AUC=0.74, P<0.0001), together with left ventricular ejection fraction (P=0.001), glycemia (P=0.019) and hemoglobin concentration (P=0.002). CONCLUSIONS: A simple prognostic index based on variables easily assessed can be useful to predict mortality in acute heart failure at the first arrival in hospital. The new index is independent from the left ventricular ejection fraction.