AHEAD score - Long-term risk classification in acute heart failure

作者：Spinar Jindrich; Jarkovsky Jiri; Spinarova Lenka; Mebazaa Alexandre; Gayat Etienne; Vitovec Jiri; Linhart Ales; Widimsky Petr; Miklik Roman; Zeman Kamil; Belohlavek Jan; Malek Filip; Felsoci Marian; Kettner Jiri; Ostadal Petr; Cihalik Cestmir; Vaclavik Jan; Taborsky Milos; Dusek Ladislav; Littnerova Simona; Parenica Jiri^*

来源：International Journal of Cardiology, 2016, 202: 21-26.

DOI：10.1016/j.ijcard.2015.08.187

• Acute heart failure
• Prognosis
• Model
• Mortality

Background: The role of co-morbidities in the prognosis of patients hospitalized for AHF was examined using the AHEAD (A - atrial fibrillation, H - haemoglobin < 130 g/l for men and 120 g/l for women (anaemia), E - elderly (age > 70 years), A - abnormal renal parameters (creatinine > 130 mu mol/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 +/- 12 years, with 61.6% of patients aged > 70 years; 43.4% were women. Atrial fibrillation was present in 30.7%, anaemia in 38.2%, creatinine > 130 mmol/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 90 month 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.

• 出版日期2016-1-1