Routine Laboratory Results and Thirty Day and One-Year Mortality Risk Following Hospitalization with Acute Decompensated Heart Failure
Open Access
- 17 August 2010
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 5 (8), e12184
- https://doi.org/10.1371/journal.pone.0012184
Abstract
Several blood tests are performed uniformly in patients hospitalized with acute decompensated heart failure and are predictive of the outcomes: complete blood count, electrolytes, renal function, glucose, albumin and uric acid. We sought to evaluate the relationship between routine admission laboratory tests results, patient characteristics and 30-day and one-year mortality of patients admitted for decompensated heart failure and to construct a simple mortality prediction tool. A retrospective population based study. Data from seven tertiary hospitals on all admissions with a principal diagnosis of heart failure during the years 2002–2005 throughout Israel were captured. 8,246 patients were included in the study cohort. Thirty day mortality rate was 8.5% (701 patients) and one-year mortality rate was 28.7% (2,365 patients). Addition of five routine laboratory tests results (albumin, sodium, blood urea, uric acid and WBC) to a set of clinical and demographic characteristics improved c-statistics from 0.76 to 0.81 for 30-days and from 0.72 to 0.76 for one-year mortality prediction (both p-values <0.0001). Three dichotomized abnormal laboratory results with highest odds ratio for one-year mortality (hypoalbuminaemia, hyponatremia and elevated blood urea) were used to construct a simple prediction score, capable of discriminating from 1.1% to 21.4% in 30-day and from 11.6% to 55.6% in one-year mortality rates between patients with a score of 0 (1,477 patients) vs. score of 3 (544 patients). A small set of abnormal routine laboratory results upon admission can risk-stratify and independently predict 30-day and one-year mortality in patients hospitalized with acute decompensated heart failure.Keywords
This publication has 31 references indexed in Scilit:
- Emerging Role of Anemia in Heart FailureThe American Journal of Cardiology, 2007
- Heart Disease and Stroke Statistics—2007 UpdateCirculation, 2007
- Temporal Increases in Subclinical Levels of Inflammation Are Associated With Adverse Clinical Outcomes in Patients With Left Ventricular DysfunctionJournal of Cardiac Failure, 2006
- The Seattle Heart Failure ModelCirculation, 2006
- Lower Serum Sodium Is Associated With Increased Short-Term Mortality in Hospitalized Patients With Worsening Heart FailureCirculation, 2005
- Hyponatremia in Congestive Heart FailureThe American Journal of Cardiology, 2005
- Uric acid and survival in chronic heart failure: Validation and application in metabolic, functional, and hemodynamic stagingJournal of the American College of Cardiology, 2003
- HyponatremiaNew England Journal of Medicine, 2000
- White blood cell count and mortality in patients with ischemic and nonischemic left ventricular systolic dysfunction (an analysis of the studies of left ventricular dysfunction [SOLVD])The American Journal of Cardiology, 1999
- A new method of classifying prognostic comorbidity in longitudinal studies: Development and validationJournal of Chronic Diseases, 1987