Discharge risk scoring method for predicting mortality in hospitalized chronic heart failure patients with severe systolic dysfunction.

Prognostic risk stratification in heart failure is crucial to guide clinical decision-making.The aim of our study was to develop a prognostic discharge risk score model to predict all-cause mortality for chronic heart failure patients with multiple co-morbidities and severe systolic dysfunction.A multivariable logistic regression model was developed with the use of data on clinical, laboratory, imaging and therapeutic findings of 630 patients with advanced systolic heart failure. A risk score model was developed based on multiplying the beta-coefficient number of each variable in the multivariable model. The model performance was evaluated by concordance index and internally validated by the bootstrapping method. 313 patients (49.7%) of the cohort died during a median follow-up duration of 54 months. Median age was 66 years, 37% were female, 26% had atrial fibrillation and 40% had diabetes mellitus. The mean left ventricular ejection fraction (EF) was 25 +/- 10% and 264 patients (42%) had left ventricular EF 7 mg/dl) and haemoglobin level (<10 g/dL). Discharge risk score identified low-, intermediate- and high-risk individuals with 18%, 40% and 52% mortality rates, respectively. The risk score had a discrimination ability with a concordance index of 0.70.In a large heart failure cohort, including patients with severe systolic dysfunction and having multiple comorbidities, a simple discharge risk score with non-invasive and easy-to-obtain variables during hospital admission represents a valuable tool for risk assessment.