Risk stratification for in-hospital mortality in acutely decompensated heart failure
Falla cardíaca descompensada: estratificación del riesgo de mortalidad intrahospitalaria hospital de San José de Bogotá DC.
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Introduction: heart failure is one of the main reasons for consultation to the emergency room and of in-hospital mor tality. Objective: to describe the risk of the latter by means of applying two instruments to patients who were hospita lized with acute decompensated heart failure at the internal medicine service at Hospital de San José de Bogotá DC. Methods: 155 patients were recruited between March 2010 and February 2011, applying the GWTG-HF risk score and the OPTIMIZE Study Risk-Prediction Nomogram, describing clinical and demographic variables. The expected and observed mortality is reported. Results: patients had an average age of 72.5 (SD 12.1) years. In-hospital mortality was documented in 7.7 % (n 12). Risk stratification was performed in 146 cases. 64.3% were classified within risk 1 to 5% by means of the AHA tool and 50.7% using the OPTIMIZE HF Nomogram. More than half of the demised patients had a low risk (1% to 15%). No concordance between methods was found (Lin 0.07). Pro BNP levels greater than 12.500 pg/ml and arrhythmia at the moment of admission were frequently reported among the group of deceased patients. These variables are not considered by the instruments that were used. Conclusions: the use of risk rates for in-hospital mortality may be a useful tool. Nevertheless, other studies are required in order to apply them on our population.
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