Incremental utility of prognostic variables at discharge for risk prediction in hospitalized patients with acutely decompensated chronic heart failure

Domenico Scrutinio, Andrea Passantino, Pietro Guida, Enrico Ammirati, Fabrizio Oliva, Rocco Lagioia, Simona Sarzi Braga, Piergiuseppe Agostoni, Maria Frigerio

Research output: Contribution to journalArticle

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 languageEnglish
Pages (from-to)212-219
Number of pages8
JournalHeart and Lung: Journal of Acute and Critical Care
Volume45
Issue number3
DOIs
Publication statusPublished - 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

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