Abstract
Objectives: To assess the incremental prognostic utility of discharge serum creatinine (SCr), systolic blood pressure (SBP), and NT-proBNP and sodium concentrations in hospitalized patients with acutely decompensated chronic heart failure. Background: Whether key prognostic variables at discharge provide incremental prognostic information beyond that provided by a model based on admission variables (referent) remains incompletely defined. Methods: The primary outcome was a composite of death, urgent heart transplantation, or ventricular assist device implantation at 1 year. The gain in predictive performance was assessed using C index, Bayesian Information Criterion, and Net Reclassification Improvement. Results: The best fit was obtained when discharge NT-proBNP was added to the referent model. No interaction between admission and discharge NT-proBNP was found. Discharge SCr, SBP, and sodium did not improve goodness-of-fit. Conclusions: Admission and discharge NT-proBNP provide complementary and independent prognostic information; as such, they should be taken into account concurrently.
Original language | English |
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Pages (from-to) | 212-219 |
Number of pages | 8 |
Journal | Heart and Lung: Journal of Acute and Critical Care |
Volume | 45 |
Issue number | 3 |
DOIs | |
Publication status | Published - May 1 2016 |
Keywords
- Acutely decompensated chronic heart failure
- Admission N-terminal Pro-B-Type natriuretic peptide
- Discharge N-terminal Pro-B-Type natriuretic peptide
- Prognosis
- Risk stratification
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Critical Care and Intensive Care Medicine
- Pulmonary and Respiratory Medicine