Prediction of recurrent heart failure hospitalizations and mortality using the echocardiographic Killip score

Area of Science:

• Cardiology
• Echocardiography
• Heart Failure Management

Background:

• Decompensated heart failure (HF) necessitates frequent hospitalizations and carries significant mortality risk.
• Predictive tools are crucial for stratifying patients and guiding post-discharge care.
• Current risk stratification often relies on clinical parameters, with limited integration of simple echocardiographic measures.

Purpose of the Study:

• To evaluate the performance of a novel, simple echocardiographic score, termed "eKillip," in predicting 30-day heart failure hospitalizations and mortality.
• To assess the eKillip score's ability to identify high-risk patients following an index hospitalization for decompensated heart failure.

Main Methods:

• A retrospective analysis included 751 patients hospitalized for decompensated heart failure between March 2019 and March 2021.
• Patients underwent echocardiography during their index admission.
• The eKillip score was derived from stroke volume index (SVI) and E/E' ratio, categorizing patients into four classes (I-IV), with Class I as reference.

Main Results:

• Patients in higher eKillip classes demonstrated a graded increase in the combined endpoint of 30-day mortality and rehospitalizations.
• This association persisted after multivariate adjustment for clinical and echocardiographic parameters.
• eKillip Class IV, representing one-third of the cohort, was consistently associated with a significantly increased risk of 30-day HF hospitalizations or mortality.

Conclusions:

• The simple echocardiographic eKillip score is a valuable tool for identifying patients at high risk of recurrent hospitalizations and mortality after decompensated heart failure.
• This score can aid clinicians in risk stratification and potentially inform treatment strategies for high-risk HF patients.