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Performance of FENNIX Score in Post-Discharge Heart Failure Appointment: A Predictor of Future Hospitalization
Session:
Sessão de Posters 21 - Insuficiência cardíaca aguda
Speaker:
Ana Filipa Mesquita Gerardo
Congress:
CPC 2024
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
11. Acute Heart Failure
Subtheme:
11.4 Acute Heart Failure– Treatment
Session Type:
Cartazes
FP Number:
---
Authors:
Ana Filipa Mesquita Gerardo; Mariana Passos; Inês Fialho; Ana Oliveira Soares; Carolina Mateus; Inês Miranda; Joana Lima Lopes; Mara Sarmento; Daniel Faria; David Roque
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Introduction and objective: </span></strong><span style="font-size:11.0pt"><span style="background-color:white"><span style="color:#212529">Several scoring systems have been developed to predict mortality and decompensations in heart failure (HF) patients recently hospitalized. We aimed to develop a simple scoring system to predict </span></span></span><span style="font-size:11.0pt"><span style="background-color:white"><span style="color:#212529">HF decompensation and cardiovascular (CV) mortality in heart failure early post discharge-appointment (EPDA)</span></span></span><span style="font-size:11.0pt"><span style="background-color:white"><span style="color:#212529">.</span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Methods:</span></strong><span style="font-size:11.0pt"> We conducted a retrospective single center study from February 2021 to September 2023 on hospitalized acute HF patients. Patients were included if they had an EPDA within 2 weeks after discharge, and laboratorial data available at discharge and at EPDA. Binary logistic regression analysis was applied to relate a broad range of admission parameters to the study endpoints. Variables with a p-value <0.05 or deemed clinically relevant were selected. A score-based prediction rule for the primary endpoint was developed using a regression coefficient-based scoring method. <span style="background-color:white"><span style="color:#212529">The primary endpoint was heart failure decompensation or CV mortality in a 3-month follow-up period. </span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Results:</span></strong><span style="font-size:11.0pt"> A total of 283 electronic charts were reviewed. Of these 119 met the inclusion criteria. Median age was 68 [IQR 57-75] years, 65.5% (n=78) males, mean left ventricle ejection fraction (LVEF) was 29.5±11,61% and median NYHA score at EDPA was II [IQR II-II]. The primary endpoint occurred in 28 patients (23.6%). Our model (FENNIx score) included five variables weighted as follows: glomerular <strong>F</strong>iltration rate ≤ 60mL/min/m2 (1point) (odds ratio [O.R.] 0.973; 95% confidence interval [CI] 0.96-0.99; p<0.0001); LV<strong>E</strong>F <35% (1 point), if LVEF <20% (2 points) (O.R. 2.057; 1.07-3.95; p=0.03); <strong>N</strong>YHA class at EPDA (1-4 points depending on the NYHA class) (O.R. 1.62; 1.05-2.509; p=0.028); <strong>N</strong>TproBNP <strong>I</strong>ncrease at EDPA (2 points); and diminished creatinine e<strong>X</strong>cretion indicated by an elevation ≥0.3 mg/dL from discharge to appointment (1 point), or an elevation ≥0.6 mg/dL (3 points) (O.R. for creatinine clearance 2.63, 1.49-4.64; p=0.001). The prognostic ability was good for receiving operator characteristics (ROC) curve with area under the curve [AUC] of 0.707 [0.591-0.823], p=0.001) (figure 1). For a one-unit increase in the score, the odds of <span style="background-color:white"><span style="color:#212529">HF decompensation or cardiovascular mortality in a 3-month follow-up period</span></span> are 1.5 times higher.</span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Conclusions:</span></strong><span style="font-size:11.0pt"> The FENNIX score (</span>https://www.calconic.com/calculator-widgets/fennix-score/657ef47ab85e7d001eb8ff1f?layouts=true<span style="font-size:11.0pt">)<strong> </strong></span><span style="font-size:11.0pt">is an easy tool with good prediction of HF decompensations and mortality in a 3-month period.</span></span></span></p>
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