Rajan Rajesh, Al Jarallah Mohammed, Al-Zakwani Ibrahim, Dashti Raja, Sulaiman Kadhim, Panduranga Prashanth, Brady Peter A, Kobalava Zhanna
Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Kuwait City, Kuwait.
Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.
Oman Med J. 2023 Jul 31;38(4):e529. doi: 10.5001/omj.2023.89. eCollection 2023 Jul.
The Rajan's heart failure (R-hf) score was proposed to aid risk stratification in heart failure patients. The aim of this study was to validate R-hf risk score in patients with acute decompensated heart failure.
R-hf risk score is derived from the product estimated glomerular filtration rate (mL/min), left ventricular ejection fraction (%), and hemoglobin levels (g/dL) divided by N-terminal pro-brain natriuretic peptide (pg/mL). This was a multinational, multicenter, prospective registry of heart failure from seven countries in the Middle East. Univariable and multivariable logistic regression was applied.
A total of 776 patients (mean age = 62.0±14.0 years, 62.4% males; mean left ventricular ejection fraction = 33.0±14.0%) were included. Of these, 459 (59.1%) presented with acute decompensated chronic heart failure. The R-hf risk score group (≤ 5) was marginally associated with a higher risk of all-cause cumulative mortality at three months (adjusted odds ratio (aOR) = 4.28; 95% CI: 0.90-20.30; 0.067) and significantly at 12 months (aOR = 3.84; 95% CI: 1.23-12.00; 0.021) when compared to those with the highest R score group (≥ 50).
Lower R-hf risk scores are associated with increased risk of all-cause cumulative mortality at three and 12 months.
提出拉詹心力衰竭（R-hf）评分以辅助心力衰竭患者的风险分层。本研究的目的是在急性失代偿性心力衰竭患者中验证R-hf风险评分。
R-hf风险评分源自估算肾小球滤过率（毫升/分钟）、左心室射血分数（%）和血红蛋白水平（克/分升）的乘积除以N末端脑钠肽前体（皮克/毫升）。这是一项来自中东七个国家的心力衰竭多中心、前瞻性登记研究。应用单变量和多变量逻辑回归分析。
共纳入776例患者（平均年龄=62.0±14.0岁，男性占62.4%；平均左心室射血分数=33.0±14.0%）。其中，459例（59.1%）为急性失代偿性慢性心力衰竭。与R评分最高组（≥50）相比，R-hf风险评分组（≤5）在3个月时全因累积死亡率风险略高（调整优势比（aOR）=4.28；95%置信区间：0.90-20.30；P=0.067），在12个月时显著更高（aOR=3.84；95%置信区间：1.23-12.00；P=0.021）。
较低的R-hf风险评分与3个月和12个月时全因累积死亡率风险增加相关。
