scholarly journals Prognostic role of the Rockwood Clinical Frailty Scale in patients with acute heart failure:results from a single-centre retrospective cohort study

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
F Todd ◽  
C Wong ◽  
L Hewitson ◽  
A Mohamed ◽  
J Doolub ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Screening Tool ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Prognostic Role ◽  
Short Term ◽  
Clinical Frailty Scale ◽  
Short Term Mortality ◽  
Comorbidity Index

Abstract Funding Acknowledgements Type of funding sources: None. Background Acute decompensated heart failure carries a poor prognosis and places a significant burden on healthcare resources. Our ability to predict patients at high risk of deterioration is limited. The Rockwood Clinical Frailty Scale (CFS) is an established frailty screening tool that stratifies patients on a nine-point scale ranging from 1 (very well) to 9 (terminally ill) providing a useful measure of physiological reserve. CFS is used extensively for general prognostication in geriatric populations, yet its impact on mortality specifically in patients admitted with acute heart failure remains sparsely investigated. Purpose We performed a retrospective cohort study to investigate the prognostic role for CFS for short term mortality in patients admitted with acute heart failure. Methods Over a period of 16 weeks (7th January – 27th April 2020), 283 consecutive patients presenting to our hospital with signs and symptoms of acute heart failure were identified. Discharge summaries, electronic notes and shared care networks were manually searched for each patient to determine frailty score, baseline demographics, admission bloods and co-morbidity indices. Short term mortality at 30 days was recorded from electronic hospital and GP records. Univariate and multivariate Cox regression analysis was performed to identify clinical and biochemical predictors of mortality. Results In total, 283 patients were admitted with acute heart failure over the study period (mean age 81+/-10 years, 46% female. The mean CFS score was 5+/-1 and mean Charlson Comorbidity Index score 8+/-3. 15% of patients died within 30 days. On univariate analysis age, creatinine, Charlson Comorbidity Index and CFS were associated with prognosis. On multivariate analysis, only CFS was found to be an independent predictor of mortality (hazard ratio 1.36, p = 0.029). Conclusion This study demonstrates a clear relationship between increasing frailty score and short-term mortality in acute heart failure. The CFS is a rapid and easily accessible screening tool used widely throughout the UK. This work highlights its potential for use alongside other parameters in prognostication of patients presenting with acute decompensated heart failure. Further work is needed to explore the impact on longer term mortality and to determine practical implementation in this setting. Abstract Figure.

scholarly journals SOFA score and short-term mortality in acute decompensated heart failure

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Adi Elias ◽  
Reham Agbarieh ◽  
Walid Saliba ◽  
Johad Khoury ◽  
Fadel Bahouth ◽  
...  
Keyword(s):  
Heart Failure ◽  
High Risk ◽  
Hospital Mortality ◽  
Sofa Score ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Short Term ◽  
High Risk Patients ◽  
Short Term Mortality ◽  
Risk Patients

AbstractAcute decompensated heart failure (ADHF) is one of the leading causes for hospitalization and mortality. Identifying high risk patients is essential to ensure proper management. Sequential Organ Function Assessment Score (SOFA) is considered an excellent score to predict short-term mortality in sepsis and other life-threatening conditions. To assess the capability of SOFA score in predicting short-term mortality in ADHF. We retrospectively identified patients with first hospitalization with primary diagnosis of ADHF between the years (2008–2018). The SOFA score was calculated for all patients. A total 3232 patients were included in the study. The SOFA score was significantly associated with in-hospital mortality and 30-day mortality. The odds ratios for 1-point increase in the SOFA score were 1.86 (95% CI 1.68–1.96) and 1.627 (95% CI 1.523–1.737) respectively. The SOFA Score demonstrated a good predictive accuracy. The areas under the curve of receiver operating characteristic curves for in-hospital mortality and 30-day mortality were 0.765 (95% CI 0.733–0.798) and 0.706 (95% CI 0.676–0.736) respectively. SOFA score is associated with increased risk of short-term mortality in ADHF. SOFA can be used as a complementary risk score to screen high risk patients who need strict monitoring.

Short-term effects of low-dose tolvaptan in acute decompensated heart failure patients with severe aortic stenosis: the LOHAS registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Watanabe ◽  
Y Nara ◽  
H Hioki ◽  
H Kawashima ◽  
A Kataoka ◽  
...  
Keyword(s):  
Heart Failure ◽  
Aortic Stenosis ◽  
Low Dose ◽  
Acute Decompensated Heart Failure ◽  
Severe Aortic Stenosis ◽  
Decompensated Heart Failure ◽  
Funding Source ◽  
Short Term ◽  
Heart Failure Patients ◽  
Short Term Effects

Abstract Background Tolvaptan exerts potent diuretic effects in heart failure patients without hemodynamic instability. Nonetheless, its clinical efficacy for acute decompensated heart failure (ADHF) due to severe aortic stenosis (AS) remains unclear. This study aimed to evaluate the short-term effects of tolvaptan in ADHF patients with severe AS. Methods The LOw-Dose Tolvaptan (7.5 mg) in Decompensated Heart Failure Patients with Severe Aortic Stenosis (LOHAS) registry is a multicenter (7 centers) prospective registry that assessed the short-term effects of tolvaptan in subjects hospitalized for ADHF with severe AS. A total of 59 subjects were enrolled between September 2014 and December 2017. The primary endpoints were changes in body weight and fluid balance measured daily from baseline up to 4 days. Results The median [interquartile range] patient age and aortic valve area were 85.0 [81.0–89.0] years and 0.58 [0.42–0.74] cm2, respectively. Body weight continuously decreased, and fluid balance was maintained from baseline to day 4 (p<0.001, p=0.194, respectively). Median serum B-type natriuretic peptide concentration significantly decreased from 910.5 to 740.0 pg/mL by day 4 (p=0.002). However, systolic blood pressure and heart rate were non-significantly changed (p=0.250, p=0.656, respectively). Hypernatremia (>150 mEq/L) and worsening renal function occurred in 2 (3.4%) and 4 (6.8%) patients, respectively. Conclusions Short-term treatment with low-dose tolvaptan is safe and effective, providing stable hemodynamic parameters in patients with ADHF and severe AS. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): This research was supported by Otsuka Pharmaceutical Co., Ltd.

Angiopoietin-Like Protein 7 and Short-Term Mortality in Acute Heart Failure

2020 ◽  
Vol 10 (2) ◽  
pp. 116-124 ◽  
Author(s):  
Chongyu Zhang ◽  
Xin He ◽  
Jingjing Zhao ◽  
Yalin Cao ◽  
Jian Liu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Inflammatory Responses ◽  
Statistical Significance ◽  
Serum Levels ◽  
Enzyme Linked Immunosorbent Assay ◽  
Short Term ◽  
Logistic Regression Models ◽  
Increased Risk ◽  
Short Term Mortality

Introduction: Angiopoietin-like protein 7 (ANGPTL7) is involved in extracellular matrix expression and inflammatory responses. However, the prognostic utility of ANGPTL7 among patients with acute heart failure (AHF) remains unclear. Objective: To evaluate the association between ANGPTL7 and short-term mortality due to AHF. Methods and Results: Patients with AHF were prospectively studied. Serum levels of ANGPTL7 were measured by an enzyme-linked immunosorbent assay. Associations between 30- and 90-day mortality and tertiles of ANGPTL7 were assessed by multivariate logistic regression models. The study comprised 142 patients. Median patient age was 68 years, and 69.7% were male. There were 20 deaths within 30 days and 37 deaths within 90 days. Crude rates of 30-day mortality in low, intermediate, and high tertiles of ANGPTL7 were 4.6, 14.6, and 22.9%, respectively. Crude rates of 90-day mortality of corresponding tertiles were 15.2, 25.0, and 37.5%. After adjusting for potential confounders, including NT-proBNP, the high tertile of ANGPTL7 was associated with a significantly increased risk of both 30-day mortality (odds ratio [OR]: 6.77, 95% confidence interval [CI]: 1.41–32.61, p = 0.017) and 90-day mortality (OR: 3.78, 95% CI: 1.38–10.36, p = 0.010) compared with the low tertile of ANGPTL7. Although mortality risk tended to be higher in the intermediate tertile than the low tertile, it did not reach statistical significance (OR: 3.75, 95% CI: 0.73–19.14, p = 0.113 for 30-day mortality; OR: 1.88, 95% CI: 0.66–5.34, p = 0.236 for 90-day mortality). Conclusions: Serum level of ANGPTL7 was independently associated with short-term mortality among patients with AHF.

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