Simple Clinical Criteria to Determine the Prognosis of Heart Failure
| Autor: | Wafaa Elatre, Ramdas G. Pai, Bonnie Huiskes, Sharon Fabbri, J. Thomas Heywood |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Male medicine.medical_specialty animal structures MEDLINE 030204 cardiovascular system & hematology Blood Urea Nitrogen 03 medical and health sciences 0302 clinical medicine Internal medicine Humans Medicine Pharmacology (medical) In patient 030212 general & internal medicine Intensive care medicine Blood urea nitrogen Aged Heart Failure Pharmacology Ejection fraction business.industry Middle Aged Prognosis medicine.disease Heart failure Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Cardiovascular Pharmacology and Therapeutics. 10:173-180 |
| ISSN: | 1940-4034 1074-2484 |
| DOI: | 10.1177/107424840501000305 |
| Popis: | Objective: To determine whether easily obtained clinical parameters serve as predictors of survival in patients with congestive heart failure. Several scoring systems to predict heart failure survival have been developed; however, many of these deal principally with transplant recipients or do not account for a patient’s response to therapy. Methods: A total of 680 patients with an ejection fraction of less than 40% were included in the analysis. Baseline assessments were performed and treatment regimens were identified; patients were then followed for up to 5 years. Univariate and multivariate Cox regression models were used to determine clinically important predictors of survival. Kaplan-Meier survival functions for patients with and without the prognostic variable were constructed and mortality was calculated at 1 year and 5 years. Results: Ejection fraction improvement at 6 months, diabetes mellitus, age, serum creatinine, and blood urea nitrogen (BUN) were significant predictors for survival in the univariate model. Ejection fraction improvement, age, and BUN were significant predictors in the multivariate model. These findings were used to construct a model for predicting patient mortality. Improved ejection fraction (>15 ejection fraction units) gave a 1-year mortality of 2% and a 5-year mortality of 11%. Mortality rates according to patient age and BUN levels were also calculated. Conclusion: Ejection fraction improvement was the most important predictor for survival in patients with systolic dysfunction; monitoring ejection fraction changes through repeat echocardiograms has important prognostic value. In patients without ejection fraction improvement, age and renal function are important survival determinants. |
| Databáze: | OpenAIRE |
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