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Prognostic Value of Unstable Clinical Index as a Simple Tool in Short-term Mortality in Patients Admitted to Hospital with Acute Heart Failure Syndromes

Author : N. N. Sitohang, Z. Syahputra, H. Hasan, A. N. Nasution
Upload Date : 19-04-2018

Background: Biomarkers play an important role in the prognosis and management of acute heart failure (AHF). Novel biomarkers are quite promising in predicting prognosis among patients with AHF. Unfortunately, biomarkers are not widely available, difficult to interpreted and expensive. Age, Heart Rate and Blood Pressure on admission are well-known in predicting outcome for AHF patients, but their new relationship called Unstable Clinical Index (UCI) hasn’t been evaluated yet.

Methods: This prospective study analyzed 255 AHF patients. UCI was defined as ratio of Heart Rate times Age to Mean Arterial Pressure (MAP) and measured on admission. Patients were categorized in 2 groups according to UCI (optimized cutt-off 71.51). Short-term survival status was obtained after 30 days. Kaplan Meier and Cox regression analysis was applied.

Results: 30.6% patients came with acute decompensated heart failure; 36.1% with acute lung edema; 26.7% with cardiogenic shock; 5.9% with hypertensive heart failure; and 0.68% with right heart failure. In short-term 87 patients had died. In Multivariate Cox regression model, short-term follow-up, the hazard ratio for death from UCI ≥71.51 was 3.456 (95% CI (2.385-5.008) p<0.001); creatinine on admission ≥2.5 mg/dL (HR: 1.826; 95% CI (1.294-2.578) p=0.001); QRS duration on ECG (HR: 1.831; 95% CI (1.310-2.559) p<0.001).

Conclusion: Unstable Clinical Index (UCI) was independent predictor of short-term mortality in patients admitted to hospital with acute heart failure syndromes. UCI is simple, low-cost and have a good prognostic value.

KEYWORDS : Unstable Clinical Index, Acute Heart Failure, Prognostic, Mortality

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