Routine Laboratory Results and Thirty Day and One-Year Mortality Risk Following Hospitalization with Acute Decompensated Heart Failure 英文参考文献.docVIP

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Routine Laboratory Results and Thirty Day and One-Year Mortality Risk Following Hospitalization with Acute Decompensated Heart Failure 英文参考文献.doc

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Routine Laboratory Results and Thirty Day and One-Year Mortality Risk Following Hospitalization with Acute Decompensated Heart Failure 英文参考文献

RoutineLaboratoryResultsandThirtyDayandOne-Year MortalityRiskFollowingHospitalizationwithAcute DecompensatedHeartFailure VictorNovack1,2*,MichaelPencina2,DoronZahger3,LiorFuchs1,RomanNevzorov1,AllanJotkowitz1, AviPorath1 1ClinicalResearchCenter,SorokaUniversityMedicalCenter,Beer-Sheva, Israel, 2HarvardClinicalResearchInstitute,Boston,Massachusetts,UnitedStatesofAmerica, 3Cardiology,SorokaUniversityMedicalCenter,Beer-Sheva,Israel Abstract Introduction:Severalbloodtestsareperformeduniformlyinpatientshospitalizedwithacutedecompensatedheartfailure andarepredictiveoftheoutcomes:completebloodcount,electrolytes,renalfunction,glucose,albuminanduricacid.We soughttoevaluatetherelationshipbetweenroutineadmissionlaboratorytestsresults,patientcharacteristicsand30-day andone-yearmortalityofpatientsadmittedfordecompensatedheartfailureandtoconstructasimplemortalityprediction tool. Methods: A retrospective population based study. Data from seven tertiary hospitals on all admissions with a principal diagnosisofheartfailureduringtheyears2002–2005throughoutIsraelwerecaptured. Results:8,246patientswereincludedinthestudycohort.Thirtydaymortalityratewas8.5%(701patients)andone-year mortalityratewas28.7%(2,365patients).Additionoffiveroutinelaboratorytestsresults(albumin,sodium,bloodurea,uric acidandWBC)toasetofclinicalanddemographiccharacteristicsimprovedc-statisticsfrom0.76to0.81for30-daysand from 0.72 to 0.76 for one-year mortality prediction (both p-values ,0.0001). Three dichotomized abnormal laboratory results with highest odds ratio for one-year mortality (hypoalbuminaemia, hyponatremia and elevated blood urea) were used toconstruct asimple prediction score, capable of discriminating from 1.1% to21.4%in 30-day andfrom11.6% to 55.6%inone-yearmortalityratesbetweenpatientswithascoreof0(1,477patients)vs.scoreof3(544patients). Discussion:Asmallsetofabnormalroutinelaboratoryresultsuponadmissioncanrisk-stratifyandindependentlypredict 30-dayandone-yearmortalityinpatientshospitalizedwith