We studied 445 patients hospitalized for AHF, defined by the presence of severe symptoms of worsening HF at admission, severely depressed LVEF, and the need for intravenous diuretic and/or inotropic drugs. The primary outcome was cumulative (in-hospital and post-discharge) mortality and post-discharge 1-year mortality. Separate analyses were performed for patients aged 鈮?70 years. A Seattle Heart Failure Score (SHFS) was calculated for each patient discharged alive.
During follow-up, 144 patients (32.4%) died, and 69 (15.5%) underwent heart transplantation (HT) or ventricular assist device (VAD) implantation. After accounting for the competing events (VAD/HT), the ADHF/NT-proBNP score鈥檚 C-statistic for cumulative mortality was 0.738 in the overall cohort and 0.771 in patients aged 鈮?70 years. The C-statistic for post-discharge mortality was 0.741 and 0.751, respectively. Adding prior (鈮? months) hospitalizations for HF to the score increased the C-statistic for post-discharge mortality to 0.759 in the overall cohort and to 0.774 in patients aged 鈮?70 years. Predicted and observed mortality rates by quartiles of score were highly correlated. The SHFS demonstrated adequate discrimination but underestimated the risk. The ADHF/NT-proBNP risk calculator is available at .
Our data suggest that the ADHF/NT-proBNP score may efficiently predict mortality in patients hospitalized with AHF.