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Heart failure
147 A practical risk score for prediction of 6-month mortality in patients with acute heart failure: CHAM2P2
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  1. Fraser Todd1,
  2. Chih Wong1,
  3. Laisha Gogola1,
  4. Andrew Skyrme-Jones1,
  5. Arjun Ghosh2,
  6. Pankaj Garg3,
  7. Eva Sammut4,
  8. Vijay Kunadian5,
  9. Mamas Mamas6,
  10. Amardeep Dastidar1
  1. 1North Bristol Trust, Bristol, UK, Southmead Hospital, Southmead Road, Bristol, BST BS10 5NB, UK
  2. 2North Bristol NHS Trust
  3. 3Barts Heart Centre, London, UK
  4. 4University of East Anglia and Norfolk and Norwich University Hospital
  5. 5University Hospitals Bristol and Weston NHS Foundation Trust, Bristol
  6. 6ewcastle Hospitals NHS Trust, University of Newcastle, Newcastle Upon Tyne, United Kingdom of Great
  7. 7eele University, Keele, United Kingdom of Great Britain & Northern Ireland

Abstract

Introduction Admission with acute heart failure carries a poor prognosis. Multiple predictive risk scores exist in heart failure presentation however the utility of these scores in acute heart failure setting among older adults is limited.

The purpose of this study was to develop a practical risk score to predict 6-month mortality in patients presenting with acute heart failure.

Methods Between January-August 2020, 474 consecutive patients ((mean age 80 ± 11 years) admitted with acute heart failure to a large tertiary hospital in the South-West of England were identified. Data was retrospectively collected on admission bloods, comorbidities, imaging, echocardiography and post discharge mortality. Prediction modelling with multivariate Cox regression was then used to identify clinically relevant predictors of six-month mortality. Continuous variables were dichotomised around the mean/median for simplification. Variables were assigned points proportional to hazard ratios on Cox regression.

Results Mortality at six months was 34% (161/474). Cox regression identified five significant (p<0.05) predictors of mortality: C: Clinical Frailty Score>5, H: hospital stay >10 days, A: age >80 yrs, M: malignancy (current or previous) history and P: NT pro-BNP>4500pg/ml. In our final model, malignancy and NT pro-BNP were assigned two points with the remainder being assigned one.

In total, 304 patients had data available to generate CHAM2P2 scores. Mortality increased sequentially from 16.0% in patients with CHAM2P2 0–2, 44.4% in patients with CHAM2P2 scores of 3–5 and 94.1% in patients with CHAM2P2 scores of 6 or 7 (log rank <0.01). AUC demonstrated good discriminatory value of the CHAM2P2 score in predicting six-month mortality (AUC 0.74).

Conclusion The CHAM2P2 score is a readily available and simple tool to predict 6-month mortality in patients admitted with acute heart failure.

View this table:
Abstract 147 Table 1

CHAM2P2 score variables and weighting

Abstract 147 Figure 1
Abstract 147 Figure 1
Abstract 147 Figure 2
Abstract 147 Figure 2

Conflict of Interest none

  • Heart failure
  • Prognosis
  • Mortality

https://doi.org/10.1136/heartjnl-2024-BCS.145

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