MEESSI-AHF score to estimate short-term prognosis of acute heart failure patients in the Emergency Department: a prospective and multicenter study.
Journal
European journal of emergency medicine : official journal of the European Society for Emergency Medicine
ISSN: 1473-5695
Titre abrégé: Eur J Emerg Med
Pays: England
ID NLM: 9442482
Informations de publication
Date de publication:
01 Dec 2023
01 Dec 2023
Historique:
medline:
30
10
2023
pubmed:
1
8
2023
entrez:
1
8
2023
Statut:
ppublish
Résumé
The assessment of acute heart failure (AHF) prognosis is primordial in emergency setting. Although AHF management is exhaustively codified using mortality predictors, there is currently no recommended scoring system for assessing prognosis. The European Society of Cardiology (ESC) recommends a comprehensive assessment of global AHF prognosis, considering in-hospital mortality, early rehospitalization rates and the length of hospital stay. We aimed to prospectively evaluate the performance of the Multiple Estimation of risk based on the Emergency department Spanish Score In patients with AHF (MEESSI-AHF) score in estimating short prognosis according to the ESC guidelines. A multicenter study was conducted between November 2020, and June 2021. Adult patients who presented to eleven French hospitals for AHF were prospectively included. According to MEESSI-AHF score, patients were stratified in four categories corresponding to mortality risk: low-, intermediate-, high- and very high-risk groups. The primary outcome was the number of days alive and out of the hospital during the 30-day period following admission to the Emergency Department (ED). In total, 390 patients were included. The number of days alive and out of the hospital decreased significatively with increasing MEESSI-AHF risk groups, ranging from 21.2 days (20.3-22.3 days) for the low-risk, 20 days (19.3-20.5 days) for intermediate risk,18.6 days (17.6-19.6 days) for the high-risk and 17.9 days (16.9-18.9 days) very high-risk category. Among patients admitted to ED for an episode of AHF, the MEESSI-AHF score estimates with good performance the number of days alive and out of the hospital.
Sections du résumé
BACKGROUND
BACKGROUND
The assessment of acute heart failure (AHF) prognosis is primordial in emergency setting. Although AHF management is exhaustively codified using mortality predictors, there is currently no recommended scoring system for assessing prognosis. The European Society of Cardiology (ESC) recommends a comprehensive assessment of global AHF prognosis, considering in-hospital mortality, early rehospitalization rates and the length of hospital stay.
OBJECTIVE
OBJECTIVE
We aimed to prospectively evaluate the performance of the Multiple Estimation of risk based on the Emergency department Spanish Score In patients with AHF (MEESSI-AHF) score in estimating short prognosis according to the ESC guidelines.
DESIGN, SETTINGS AND PATIENTS
UNASSIGNED
A multicenter study was conducted between November 2020, and June 2021. Adult patients who presented to eleven French hospitals for AHF were prospectively included.
OUTCOME MEASURES AND ANALYSIS
METHODS
According to MEESSI-AHF score, patients were stratified in four categories corresponding to mortality risk: low-, intermediate-, high- and very high-risk groups. The primary outcome was the number of days alive and out of the hospital during the 30-day period following admission to the Emergency Department (ED).
RESULTS
RESULTS
In total, 390 patients were included. The number of days alive and out of the hospital decreased significatively with increasing MEESSI-AHF risk groups, ranging from 21.2 days (20.3-22.3 days) for the low-risk, 20 days (19.3-20.5 days) for intermediate risk,18.6 days (17.6-19.6 days) for the high-risk and 17.9 days (16.9-18.9 days) very high-risk category.
CONCLUSION
CONCLUSIONS
Among patients admitted to ED for an episode of AHF, the MEESSI-AHF score estimates with good performance the number of days alive and out of the hospital.
Identifiants
pubmed: 37526107
doi: 10.1097/MEJ.0000000000001064
pii: 00063110-202312000-00011
doi:
Types de publication
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
424-431Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Références
Zannad F, Briancon S, Juilliere Y, Mertes PM, Villemot JP, Alla F, et al. Incidence, clinical and etiologic features, and outcomes of advanced chronic heart failure: the EPICAL study. Epidémiologie de l’Insuffisance Cardiaque Avancée en Lorraine. J Am Coll Cardiol 1999; 33:734–742.
Emmons-Bell S, Johnson C, Roth G. Prevalence, incidence and survival of heart failure: a systematic review. Heart 2022; 108:1351–1360.
Lloyd-Jones DM, Larson MG, Leip EP, Beiser A, D’Agostino RB, Kannel WB, et al.; Framingham Heart Study. Lifetime risk for developing congestive heart failure: the Framingham Heart Study. Circulation 2002; 106:3068–3072.
Driscoll A, Meagher S, Kennedy R, Hay M, Banerji J, Campbell D, et al. What is the impact of systems of care for heart failure on patients diagnosed with heart failure: a systematic review. BMC Cardiovasc Disord 2016; 16:195.
Boom NK, Lee DS, Tu JV. Comparison of processes of care and clinical outcomes for patients newly hospitalized for heart failure attended by different physician specialists. Am Heart J 2012; 163:252–259.
Gorlicki J, Boubaya M, Cottin Y, Angoulvant D, Soulat L, Guinemer S, et al. Patient care pathways in acute heart failure and their impact on in-hospital mortality, a French national prospective survey. Int J Cardiol Heart Vasc 2020; 26:100448.
Miró O, Gil V, Martín-Sánchez FJ, Herrero P, Jacob J, Sánchez C, et al.; en nombre del grupo de investigación ICA-SEMES. Short-term reconsultation, hospitalisation, and death rates after discharge from the emergency department in patients with acute heart failure and analysis of the associated factors. The ALTUR-ICA Study. Med Clin (Barc) 2018; 150:167–177.
Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, et al.; Authors/Task Force Members. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 2016; 18:891–975.
Adams KF, Fonarow GC, Emerman CL, LeJemtel TH, Costanzo MR, Abraham WT, et al.; ADHERE Scientific Advisory Committee and Investigators. Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE). Am Heart J 2005; 149:209–216.
Cleland JGF, McDonagh T, Rigby AS, Yassin A, Whittaker T, Dargie HJ; National Heart Failure Audit Team for England and Wales. The national heart failure audit for England and Wales 2008-2009. Heart 2011; 97:876–886.
Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the medicare fee-for-service program. N Engl J Med 2009; 360:1418–1428.
Gheorghiade M, Vaduganathan M, Fonarow GC, Bonow RO. Rehospitalization for heart failure: problems and perspectives. J Am Coll Cardiol 2013; 61:391–403.
Bueno H, Ross JS, Wang Y, Chen J, Vidán MT, Normand SLT, et al. Trends in length of stay and short-term outcomes among Medicare patients hospitalized for heart failure, 1993-2006. JAMA 2010; 303:2141–2147.
Chouihed T, Manzo-Silberman S, Peschanski N, Charpentier S, Elbaz M, Savary D, et al. Management of suspected acute heart failure dyspnea in the emergency department: results from the French prospective multicenter DeFSSICA survey. Scand J Trauma Resusc Emerg Med 2016; 24:112.
Urbich M, Globe G, Pantiri K, Heisen M, Bennison C, Wirtz HS, et al. A systematic review of medical costs associated with heart failure in the USA (2014–2020. PharmacoEcon 2020; 38:1219–1236.
Lesyuk W, Kriza C, Kolominsky-Rabas P. Cost-of-illness studies in heart failure: a systematic review 2004-2016. BMC Cardiovasc Disord 2018; 18:74.
Miró O, Rossello X, Gil V, Martín-Sánchez FJ, Llorens P, Herrero-Puente P, et al.; ICA-SEMES Research Group. Predicting 30-day mortality for patients with acute heart failure in the emergency department: a cohort study. Ann Intern Med 2017; 167:698–705.
Wussler D, Kozhuharov N, Sabti Z, Walter J, Strebel I, Scholl L, et al. External validation of the MEESSI acute heart failure risk score: a cohort study. Ann Intern Med 2019; 170:248–256.
Rossello X, Bueno H, Gil V, Jacob J, Javier Martín-Sánchez F, Llorens P, et al. MEESSI-AHF risk score performance to predict multiple post-index event and post-discharge short-term outcomes. Eur Heart J Acute Cardiovasc Care 2021; 10:142–152.
Roncalli J, Picard F, Delarche N, Faure I, Pradeau C, Thicoipe M, et al. Predictive criteria for acute heart failure in emergency department patients with acute dyspnoea: the PREDICA study. Eur J Emerg Med 2019; 26:400–404.
Dunlay SM, Redfield MM, Weston SA, Therneau TM, Hall Long K, Shah ND, et al. Hospitalizations after heart failure diagnosis a community perspective. J Am Coll Cardiol 2009; 54:1695–1702.
Gayat E, Arrigo M, Littnerova S, Sato N, Parenica J, Ishihara S, et al.; GREAT Network. Heart failure oral therapies at discharge are associated with better outcome in acute heart failure: a propensity-score matched study. Eur J Heart Fail 2018; 20:345–354.
Zuily S, Jourdain P, Decup D, Agrinier N, Loiret J, Groshens S, et al. Impact of heart failure management unit on heart failure-related readmission rate and mortality. Arch Cardiovasc Dis 2010; 103:90–96.
Kul S, Barbieri A, Milan E, Montag I, Vanhaecht K, Panella M. Effects of care pathways on the in-hospital treatment of heart failure: a systematic review. BMC Cardiovasc Disord 2012; 12:81.
Freund Y, Cachanado M, Delannoy Q, Laribi S, Yordanov Y, Gorlicki J, et al. Effect of an emergency department care bundle on 30-day hospital discharge and survival among elderly patients with acute heart failure: The ELISABETH Randomized Clinical Trial. JAMA 2020; 324:1948–1956.
Cluzol L, Cautela J, Michelet P, Roch A, Kerbaul F, Mancini J, et al. Prehospital and in-hospital course of care for patients with acute heart failure: features and impact on prognosis in « real life. Arch Cardiovasc Dis 2017; 110:72–81.
Logeart D, Isnard R, Resche-Rigon M, Seronde MF, de Groote P, Jondeau G, et al.; Heart Failure of the French Society of Cardiology. Current aspects of the spectrum of acute heart failure syndromes in a real-life setting: the OFICA study. Eur J Heart Fail 2013; 15:465–476.
Ray P, Birolleau S, Lefort Y, Becquemin MH, Beigelman C, Isnard R, et al. Acute respiratory failure in the elderly: etiology, emergency diagnosis and prognosis. Crit Care 2006; 10:R82.
Korenstein D, Wisnivesky JP, Wyer P, Adler R, Ponieman D, McGinn T. The utility of B-type natriuretic peptide in the diagnosis of heart failure in the emergency department: a systematic review. BMC Emerg Med 2007; 7:6.
Chung T, Sindone A, Foo F, Dwyer A, Paoloni R, Janu MR, et al. Influence of history of heart failure on diagnostic performance and utility of B-type natriuretic peptide testing for acute dyspnea in the emergency department. Am Heart J 2006; 152:949–955.
Bayés-Genís A, Santaló-Bel M, Zapico-Muñiz E, López L, Cotes C, Bellido J, et al. N-terminal probrain natriuretic peptide (NT-proBNP) in the emergency diagnosis and in-hospital monitoring of patients with dyspnoea and ventricular dysfunction. Eur J Heart Fail 2004; 6:301–308.
Doust JA, Glasziou PP, Pietrzak E, Dobson AJ. A systematic review of the diagnostic accuracy of natriuretic peptides for heart failure. Arch Intern Med 2004; 164:1978–1984.