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Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
Outcome prediction in acute decompensated heart failure using the BAN-ADHF score across LVEF: Analysis in an internal
Amelia Campos-Saenz de Santamaría1, Marc Godos-Gómez2, Silvia Crespo-Aznarez1
1Internal Medicine Department, Hospital Clínico Lozano Blesa, Zaragoza, Spain; Aragon Health Research Institute (IIS Aragon), Zaragoza, Spain.
Insights
The BAN-ADHF score effectively identifies high-risk heart failure patients, predicting increased mortality and hospital readmissions. This score aids in personalized risk stratification and guides early treatment strategies in real-world settings.
Area of Science:
- Cardiology
- Clinical Medicine
- Health Services Research
Background:
- The BAN-ADHF score predicts diuretic efficiency and adverse events in heart failure (HF).
- Its real-world performance and utility across left ventricular ejection fraction (LVEF) phenotypes require further investigation.
- Current understanding of the BAN-ADHF score's effectiveness in diverse clinical settings is limited.
Purpose of the Study:
- To evaluate the real-world performance of the BAN-ADHF score in predicting adverse outcomes.
- To assess the BAN-ADHF score's predictive accuracy across different LVEF phenotypes.
- To determine the score's utility in stratifying risk for mortality and HF rehospitalization.
Main Methods:
- Retrospective observational study of 472 patients hospitalized for HF between 2018 and 2024.
- Patients were categorized into low (<12) and high-risk (≥12) groups using the BAN-ADHF score.
- Primary endpoint: all-cause mortality and/or HF rehospitalization at 180 days and one year.
Main Results:
- High-risk patients (22.9%) were older, more frequently male, and had higher comorbidity burden.
- The composite endpoint occurred in 64% of high-risk vs. 30% of low-risk patients at 180 days (p<0.001).
- High-risk status independently predicted adverse events (HR 2.8, p<0.001) with acceptable predictive capacity (C-index 0.65).
Conclusions:
- The BAN-ADHF score reliably identifies high-risk patients with significantly increased adverse events, including mortality and readmission.
- The score's predictive value was consistent across LVEF phenotypes in this real-world cohort.
- Integrating the BAN-ADHF score into routine care may optimize therapeutic strategies and resource allocation for HF patients.
Background:
The BAN-ADHF score integrates clinical, biomarker, and diuretic data to predict low diuretic efficiency and adverse events, offering a tool for individualized risk stratification. However, its performance in real-world settings remains understudied. No previous studies analyzed its usefulness across left ventricular ejection fraction (LVEF) phenotypes.
Methods:
Observational and retrospective study carried out at the Internal Medicine Ward of a tertiary hospital between 2018 and 2024. Patients were classified into low (<12) and high-risk (≥12) groups. The primary endpoint was all-cause mortality and/or rehospitalization for heart failure (HF) at 180 days.
Results:
A total of 472 patients were eligible. The mean age was 79.6±9.4 years with 47.8% female and 64.6% of HF with preserved LVEF. Based on the BAN-ADHF score, 77.1% were categorized as "low-risk", while 22.9% were classified as "high-risk". High-risk patients were older (p=0.019), more frequently male (p<0.001), and had a higher comorbidity burden. At 180 days, the composite endpoint occurred in 30% of low-risk versus 64% of high-risk patients (p<0.001). Mortality was 13.5% versus 41% (p<0.001), and HF rehospitalization 42% versus 76% (p<0.001). At one year, the combined outcome was 45% versus 76% (p<0.001). High-risk status remained an independent predictor of adverse events (HR 2.8, 95% CI 2.1-3.8, p<0.001). The BAN-ADHF score demonstrated acceptable predictive capacity (C-index 0.65).
Conclusions:
The BAN-ADHF score reliably identifies high-risk patients with a significantly greater incidence of adverse events, independently including readmission, mortality, and their composite at 180 days in a real-world cohort regardless LVEF. Its integration into routine care may help guide early therapeutic strategies and resource allocation.
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