Abstract

Introduction: Delay hospitalization in acute heart failure patients was the risk of complications, delay definite diagnosis, and treatment. This study aims to create a predictive score to predict hospitalization in acute heart failure patients.

Methods: Retrospective cohort design and collected data of acute heart failure patients in the emergency department. Predictive factors obtained from patients’ characteristics, underlying diseases, medical signs, vital signs on admission, a preliminary examination in the emergency department, and factors were stimulating acute heart failure in patients. Predictive factors were chosen from multivariable logistic regression and converted into predictive scores.

Result: 151 patients stayed in the hospital for more than 24 hours, and 62 patients stayed in the hospital for less than 24 hours. Predictive factors included NYHA (New York Heart Association) functional class, temperature, and patients’ breathing rate observed on admission, albumin levels, factors stimulating acute heart failure in patients caused by the acute coronary syndrome. Scores could predict more than 24 hours of hospital stay. AuROC was 85.27% (95% CI; 79.82, 90.73). Predictive scores were divided into 3 groups as the group with high scores (7.5-13.5), moderate scores (3.5-7), and low scores (0-3) being at risk of hospitalization longer than 1- day by 100%, 72.7% (95% CI;65.7, 79.8) and 16.7% (95% CI; 1.8, 31.6) respectively.

Conclusion: The scores can be used to predict hospitalization or ED length of stay for more than 24 hours for acutely decompensated heart failure patients in the emergency department.