A Novel In-hospital Congestion Score to Risk Stratify Patients Admitted for Worsening Heart Failure (from ASCEND-HF).

Journal Article (Journal Article)

Patients hospitalized for heart failure (HF) remain at high risk for early readmission. A post hoc analysis was performed of the biomarker substudy of the ASCEND-HF trial. An in-hospital congestion score was derived using orthopnea, pedal edema, and NT-proBNP levels. Its added prognostic value beyond traditional risk factors was assessed by determining the net reclassification index (NRI). Study participants (n = 884) had a median age (years) of 67 (55-77), 68% were male, and the median (25th-75th) ejection fraction (%) was 26 (20-40). After adjustment, increasing congestion score was associated with 30-day all-cause mortality or HF hospitalization (odds ratio = 1.51, 95% confidence interval [CI] 1.28-1.77, p < 0.001) and 180-day all-cause mortality (hazard ratio = 1.48, 95% CI 1.28-1.72, p < 0.001). However, adding the congestion score to the multivariable model did not significantly impact the NRI. A higher in-hospital congestion score portended a poor short-term prognosis but did not significantly reclassify risk.

Full Text

Duke Authors

Cited Authors

  • Masson, R; Ambrosy, AP; Kheder, K; Fudim, M; Clare, RM; Coles, A; Hernandez, AF; Starling, RC; Ezekowitz, JA; O'Connor, CM; Mentz, RJ

Published Date

  • August 2020

Published In

Volume / Issue

  • 13 / 4

Start / End Page

  • 540 - 548

PubMed ID

  • 31933144

Electronic International Standard Serial Number (EISSN)

  • 1937-5395

Digital Object Identifier (DOI)

  • 10.1007/s12265-020-09954-x


  • eng

Conference Location

  • United States