Abstract
BACKGROUND: Prediction of in-hospital mortality in acute heart failure (AHF) is sought to evaluate the blood pressure and renal function. Acute heart failure with systolic pressure and impaired renal function is common but not well understood. METHODS: We reviewed 187 patients with acute heart failure from 2013-2014. Then we apply validation of a risk stratification tool to predict in-hospital mortality for acute HF group. The analysis of the inhospital mortality with acute heart failure group will based on BUN level, systolic blood pressure, and serum creatinine level. RESULTS: There were 23 patients in the in-hospital mortality group and 164 patients in the survived group after hospitalization. The 3 physiological parameters were compared between in-hospital mortality and survival group from the validation of a risk stratification tool: systolic blood pressure (123.7 ± 30.1 vs. 143.7 ± 34.2 mmHg, p value = 0.009), blood urea nitrogen (57.2 ± 27.7 vs. 38.7 ± 24.7 mg/dL, p value = 0.001), serum creatinine (2.38 ± 1.91 vs. 2.06 ± 1.62 mg/dL, p value = 0.390). Finding from NTUH compared with ADHERE was the group with blood urea nitrogen 43 mg/dL, systolic BP < 115 mmHg, and serum creatinine < 2.75 mg/dL will be high risk of in-hospital mortality (50% in NTUH vs. 12.42% in ADHERE). In our validation of a risk stratification tool, the accuracy was 77.8 % by receiver operator characteristic curve analysis. CONCLUSION: On the basis of these 3 variables- BUN level, systolic blood pressure, and serum creatinine level from the current analysis, the acute heart failure patient can be readily stratified into groups at high risk for in-hospital mortality.