Non-Biomarker Bedside Risk Scores for One-Year Mortality After Acute Heart Failure Hospitalization

Area of Science:

• Cardiology
• Clinical Risk Stratification
• Public Health

Background:

• Acute heart failure (AHF) hospitalization requires effective risk stratification, especially post-discharge.
• Biomarker testing and comprehensive registry data may be unavailable in certain settings.
• Simple, non-biomarker bedside scores can aid risk assessment in resource-limited environments.

Purpose of the Study:

• To evaluate the utility of non-biomarker bedside risk scores for predicting 1-year all-cause mortality in patients hospitalized for AHF in Vietnam.
• To assess the prognostic performance of a simplified, expanded eight-item score using routine clinical variables.

Main Methods:

• A retrospective cohort study included 497 adult patients hospitalized for AHF in Vietnam (January-August 2021).
• Vital status was ascertained for 1 year post-discharge.
• An eight-item, non-biomarker score (age, NYHA class, SBP, HR, Na, creatinine, LVEF, hemoglobin) was evaluated. Discrimination was assessed using AUC and likelihood ratios.

Main Results:

• Among 497 patients, 11.5% died within 1 year.
• The expanded eight-item score achieved an AUC of 0.590 (95% CI, 0.509-0.660).
• Observed mortality increased with higher score groups, but a cross-validated clinical model using the same variables showed better discrimination (AUC 0.671).

Conclusions:

• Simple, non-biomarker point scores offer modest prognostic information for 1-year mortality after AHF hospitalization in this Vietnamese cohort.
• These scores are best used for broad risk orientation rather than definitive individual prognostication.
• External validation is recommended prior to widespread clinical implementation.