AHEAD score - Long-term risk classification in acute heart failure.
Int J Cardiol. 2015 Aug 28;202:21-26
Authors: Spinar J, Jarkovsky J, Spinarova L, Mebazaa A, Gayat E, Vitovec J, Linhart A, Widimsky P, Miklik R, Zeman K, Belohlavek J, Malek F, Felsoci M, Kettner J, Ostadal P, Cihalik C, Vaclavik J, Taborsky M, Dusek L, Littnerova S, Parenica J
Abstract
BACKGROUND: The role of co-morbidities in the prognosis of patients hospitalized for AHF was examined using the AHEAD (A - atrial fibrillation, H - haemoglobin<130g/l for men and 120g/l for women (anaemia), E - elderly (age>70years), A - abnormal renal parameters (creatinine>130μmol/l), D - diabetes mellitus) scoring system.
METHODS: AHEAD - multicentre prospective Czech registry of AHF patients; GREAT registry - international cohort of AHF patients. Data from 5846 consecutive patients hospitalized for AHF (AHEAD registry; derivation cohort) were analysed to build the AHEAD score. Each risk factor of the AHEAD score was counted as 1 point. The model was validated externally using an international cohort of similar patients in the GREAT registry (6315).
RESULTS: Main outcome was one year all-cause mortality. The mean age of patients was 72±12years, with 61.6% of patients aged >70years; 43.4% were women. Atrial fibrillation was present in 30.7%, anaemia in 38.2%, creatinine >130mmol/l (abnormal renal parameters) in 30.1%, and diabetes mellitus in 44.0%. The mean AHEAD score was 2.1. In patients with AHEAD scores of 0-5, the one-year mortality rates were 13.6%, 23.4%, 32.0%, 41.1%, 47.7%, and 58.2%, respectively (p<0.001), and the 90month mortality rates were 35.1%, 57.3%, 73.5%, 84.8%, 88.0%, and 91.7%, respectively (p<0.001).
CONCLUSION: The AHEAD is a simple scoring system based on the analysis of co-morbidities for the estimation of the short and long term prognosis of patients hospitalized for AHF.
PMID: 26386914 [PubMed - as supplied by publisher]