Context: Estimation of mortality risk in patients hospitalized with acute decompensated heart failure (ADHF) may help clinicians guide care VSports手机版. .

Objective: To develop a practical user-friendly bedside tool for risk stratification for patients hospitalized with ADHF V体育安卓版. .

Design, setting, and patients: The Acute Decompensated Heart Failure National Registry (ADHERE) of patients hospitalized with a primary diagnosis of ADHF in 263 hospitals in the United States was queried with analysis of patient data to develop a risk stratification model. The first 33,046 hospitalizations (derivation cohort; October 2001-February 2003) were analyzed to develop the model and then the validity of the model was prospectively tested using data from 32,229 subsequent hospitalizations (validation cohort; March-July 2003). Patients had a mean age of 72. 5 years and 52% were female V体育ios版. .

Main outcome measure: Variables predicting mortality in ADHF VSports最新版本. .

Results: When the derivation and validation cohorts are combined, 37,772 (58%) of 65,275 patient-records had coronary artery disease. Of a combined cohort consisting of 52,164 patient-records, 23,910 (46%) had preserved left ventricular systolic function. In-hospital mortality was similar in the derivation (4. 2%) and validation (4. 0%) cohorts. Recursive partitioning of the derivation cohort for 39 variables indicated that the best single predictor for mortality was high admission levels of blood urea nitrogen (> or =43 mg/dL [15 V体育平台登录. 35 mmol/L]) followed by low admission systolic blood pressure (<115 mm Hg) and then by high levels of serum creatinine (> or =2. 75 mg/dL [243. 1 micromol/L]). A simple risk tree identified patient groups with mortality ranging from 2. 1% to 21. 9%. The odds ratio for mortality between patients identified as high and low risk was 12. 9 (95% confidence interval, 10. 4-15. 9) and similar results were seen when this risk stratification was applied prospectively to the validation cohort. .

Conclusions: These results suggest that ADHF patients at low, intermediate, and high risk for in-hospital mortality can be easily identified using vital sign and laboratory data obtained on hospital admission. The ADHERE risk tree provides clinicians with a validated, practical bedside tool for mortality risk stratification. VSports注册入口.