Prognostic Value of the PROFUND Index for 30-Day Mortality in Acute Heart Failure
<i>Background and Objectives:</i> The prevalence and incidence of heart failure (HF) have been increasing in recent years as the population ages. These patients show a distinct profile of comorbidity, which makes their care more complex. In recent years, the PROFUND index, a specific too...
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oai:doaj.org-article:07434711ef3d4c54b0c2da555b5c246f2021-11-25T18:18:06ZPrognostic Value of the PROFUND Index for 30-Day Mortality in Acute Heart Failure10.3390/medicina571111501648-91441010-660Xhttps://doaj.org/article/07434711ef3d4c54b0c2da555b5c246f2021-10-01T00:00:00Zhttps://www.mdpi.com/1648-9144/57/11/1150https://doaj.org/toc/1010-660Xhttps://doaj.org/toc/1648-9144<i>Background and Objectives:</i> The prevalence and incidence of heart failure (HF) have been increasing in recent years as the population ages. These patients show a distinct profile of comorbidity, which makes their care more complex. In recent years, the PROFUND index, a specific tool for estimating the mortality rate at one year in pluripathology patients, has been developed. The aim of this study was to evaluate the prognostic value of the PROFUND index and of in-hospital and 30-day mortality after discharge of patients admitted for acute heart failure (AHF). <i>Materials and Methods</i>: A prospective multicenter longitudinal study was performed that included patients admitted with AHF and ≥2 comorbid conditions. Clinical, analytical, and prognostic variables were collected. The PROFUND index was collected in all patients and rates of in-hospital and 30-day mortality after discharge were analyzed. A bivariate analysis was performed with quantitative variables between patients who died and those who survived at the 30-day follow-up. A logistic regression analysis was performed with the variables that obtained statistical significance in the bivariate analysis between deceased and surviving subjects. <i>Results:</i> A total of 128 patients were included. Mean age was 80.5 +/− 9.98 years, and women represented 51.6%. The mean PROFUND index was 5.26 +/− 4.5. The mortality rate was 8.6% in-hospital and 20.3% at 30 days. Preserved left ventricular ejection fraction was found in 60.9%. In the sample studied, there were patients with a PROFUND score < 7 predominated (89 patients (70%) versus 39 patients (31%) with a PROFUND score ≥ 7). Thirteen patients (15%) with a PROFUND score < 7 died versus the 13 (33%) with a PROFUND score ≥ 7, <i>p</i> = 0.03. Twelve patients (15%) with a PROFUND score < 7 required readmission versus 12 patients (35%) with a PROFUND score ≥ 7, <i>p</i> = 0.02. The ROC curve of the PROFUND index for in-hospital mortality and 30-day follow-up in patients with AHF showed AUC 0.63, CI: 95% (0.508–0.764), <i>p</i> <0.033. <i>Conclusions:</i> The PROFUND index is a clinical tool that may be useful for predicting short-term mortality in elderly patients with AHF. Further studies with larger simple sizes are required to validate these results.Manuel Méndez-BailónRosario Iguarán-BermúdezLidia López-GarcíaBeatriz Sánchez-SaucePablo Pérez-MateosJulia Barrado-CuchilloMiguel Villar-MartínezSantiago Fernández-CastelaoJose Luis García-KlepzigManuel Enrique Fuentes-FerrerAlejandra García-GarcíaIsidre VilacostaJosé María de Miguel-YanesJosé Manuel Casas-RojoElpidio Calvo-ManuelEmmanuel AndresNoel Lorenzo-Villalbaon behalf of the Heart Failure and Pluripathology Groups from the Spanish National Society of Internal MedicineMDPI AGarticleheart failurePROFUND indexpluripathologyMedicine (General)R5-920ENMedicina, Vol 57, Iss 1150, p 1150 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
heart failure PROFUND index pluripathology Medicine (General) R5-920 |
| spellingShingle |
heart failure PROFUND index pluripathology Medicine (General) R5-920 Manuel Méndez-Bailón Rosario Iguarán-Bermúdez Lidia López-García Beatriz Sánchez-Sauce Pablo Pérez-Mateos Julia Barrado-Cuchillo Miguel Villar-Martínez Santiago Fernández-Castelao Jose Luis García-Klepzig Manuel Enrique Fuentes-Ferrer Alejandra García-García Isidre Vilacosta José María de Miguel-Yanes José Manuel Casas-Rojo Elpidio Calvo-Manuel Emmanuel Andres Noel Lorenzo-Villalba on behalf of the Heart Failure and Pluripathology Groups from the Spanish National Society of Internal Medicine Prognostic Value of the PROFUND Index for 30-Day Mortality in Acute Heart Failure |
| description |
<i>Background and Objectives:</i> The prevalence and incidence of heart failure (HF) have been increasing in recent years as the population ages. These patients show a distinct profile of comorbidity, which makes their care more complex. In recent years, the PROFUND index, a specific tool for estimating the mortality rate at one year in pluripathology patients, has been developed. The aim of this study was to evaluate the prognostic value of the PROFUND index and of in-hospital and 30-day mortality after discharge of patients admitted for acute heart failure (AHF). <i>Materials and Methods</i>: A prospective multicenter longitudinal study was performed that included patients admitted with AHF and ≥2 comorbid conditions. Clinical, analytical, and prognostic variables were collected. The PROFUND index was collected in all patients and rates of in-hospital and 30-day mortality after discharge were analyzed. A bivariate analysis was performed with quantitative variables between patients who died and those who survived at the 30-day follow-up. A logistic regression analysis was performed with the variables that obtained statistical significance in the bivariate analysis between deceased and surviving subjects. <i>Results:</i> A total of 128 patients were included. Mean age was 80.5 +/− 9.98 years, and women represented 51.6%. The mean PROFUND index was 5.26 +/− 4.5. The mortality rate was 8.6% in-hospital and 20.3% at 30 days. Preserved left ventricular ejection fraction was found in 60.9%. In the sample studied, there were patients with a PROFUND score < 7 predominated (89 patients (70%) versus 39 patients (31%) with a PROFUND score ≥ 7). Thirteen patients (15%) with a PROFUND score < 7 died versus the 13 (33%) with a PROFUND score ≥ 7, <i>p</i> = 0.03. Twelve patients (15%) with a PROFUND score < 7 required readmission versus 12 patients (35%) with a PROFUND score ≥ 7, <i>p</i> = 0.02. The ROC curve of the PROFUND index for in-hospital mortality and 30-day follow-up in patients with AHF showed AUC 0.63, CI: 95% (0.508–0.764), <i>p</i> <0.033. <i>Conclusions:</i> The PROFUND index is a clinical tool that may be useful for predicting short-term mortality in elderly patients with AHF. Further studies with larger simple sizes are required to validate these results. |
| format |
article |
| author |
Manuel Méndez-Bailón Rosario Iguarán-Bermúdez Lidia López-García Beatriz Sánchez-Sauce Pablo Pérez-Mateos Julia Barrado-Cuchillo Miguel Villar-Martínez Santiago Fernández-Castelao Jose Luis García-Klepzig Manuel Enrique Fuentes-Ferrer Alejandra García-García Isidre Vilacosta José María de Miguel-Yanes José Manuel Casas-Rojo Elpidio Calvo-Manuel Emmanuel Andres Noel Lorenzo-Villalba on behalf of the Heart Failure and Pluripathology Groups from the Spanish National Society of Internal Medicine |
| author_facet |
Manuel Méndez-Bailón Rosario Iguarán-Bermúdez Lidia López-García Beatriz Sánchez-Sauce Pablo Pérez-Mateos Julia Barrado-Cuchillo Miguel Villar-Martínez Santiago Fernández-Castelao Jose Luis García-Klepzig Manuel Enrique Fuentes-Ferrer Alejandra García-García Isidre Vilacosta José María de Miguel-Yanes José Manuel Casas-Rojo Elpidio Calvo-Manuel Emmanuel Andres Noel Lorenzo-Villalba on behalf of the Heart Failure and Pluripathology Groups from the Spanish National Society of Internal Medicine |
| author_sort |
Manuel Méndez-Bailón |
| title |
Prognostic Value of the PROFUND Index for 30-Day Mortality in Acute Heart Failure |
| title_short |
Prognostic Value of the PROFUND Index for 30-Day Mortality in Acute Heart Failure |
| title_full |
Prognostic Value of the PROFUND Index for 30-Day Mortality in Acute Heart Failure |
| title_fullStr |
Prognostic Value of the PROFUND Index for 30-Day Mortality in Acute Heart Failure |
| title_full_unstemmed |
Prognostic Value of the PROFUND Index for 30-Day Mortality in Acute Heart Failure |
| title_sort |
prognostic value of the profund index for 30-day mortality in acute heart failure |
| publisher |
MDPI AG |
| publishDate |
2021 |
| url |
https://doaj.org/article/07434711ef3d4c54b0c2da555b5c246f |
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