Evidence map›Paper›PMID 33566969›Full record

Observational studyArquivos brasileiros de cardiologia2021

Acute Hemodynamic Index Predicts In-Hospital Mortality in Acute Decompensated Heart Failure.

Renata R T Castro, Luka Lechnewski, Alan Homero, Denilson Campos de Albuquerque, Luis Eduardo Rohde, Dirceu Almeida, João David, Salvador Rassi, Fernando Bacal, Edimar Bocchi and 1 more

Abstract readMulticenter StudyObservational Study
In one paragraph

Observational study in Arquivos brasileiros de cardiologia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Renata R T CastroBrigham and Womens Hospital - Medicine, Boston - EUA.ORCID 0000-0001-5560-693X
Luka LechnewskiPontifícia Universidade Católica do Paraná, Curitiba, PR - Brasil.
Alan HomeroPontifícia Universidade Católica do Paraná, Curitiba, PR - Brasil.
Denilson Campos de AlbuquerqueUniversidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ - Brasil.
Luis Eduardo RohdeUniversidade Federal do Rio Grande do Sul, Porto Alegre, RS - Brasil.
Dirceu AlmeidaUniversidade Federal de São Paulo, São Paulo, SP - Brasil.ORCID 0000-0002-2178-1518
João DavidHospital de Messejana, Fortaleza, CE - Brasil.
Salvador RassiUniversidade Federal de Goiás, Goiânia, GO - Brasil.
Fernando BacalUniversidade de São Paulo Instituto do Coração, São Paulo, SP - Brasil.
Edimar BocchiUniversidade de São Paulo Instituto do Coração, São Paulo, SP - Brasil.
Lidia MouraPontifícia Universidade Católica do Paraná, Curitiba, PR - Brasil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe physical examination enables prognostic evaluation of patients with decompensated heart failure (HF), but lacks reliability and relies on the professional's clinical experience. Considering hemodynamic responses to "fight or flight" situations, such as the moment of admission to the emergency room, we proposed the calculation of the acute hemodynamic index (AHI) from values of heart rate and pulse pressure.

objectiveTo evaluate the in-hospital prognostic ability of AHI in decompensated HF.

methodsA prospective, multicenter, registry-based observational study including data from the BREATHE registry, with information from public and private hospitals in Brazil. The prognostic ability of the AHI was tested by receiver-operating characteristic (ROC) analyses, C-statistics, Akaike's information criteria, and multivariate regression analyses. p-values < 0.05 were considered statistically significant.

resultsWe analyzed data from 463 patients with heart failure with low ejection fraction. In-hospital mortality was 9%. The median AHI value was used as cut-off (4 mmHg⋅bpm). A low AHI (≤ 4 mmHg⋅bpm) was found in 80% of deceased patients. The risk of in-hospital mortality in patients with low AHI was 2.5 times that in patients with AHI > 4 mmHg⋅bpm. AHI independently predicted in-hospital mortality in acute decompensated HF (sensitivity: 0.786; specificity: 0.429; AUC: 0.607 [0.540-0.674]; p = 0.010) even after adjusting for comorbidities and medication use [OR: 0.061 (0.007-0.114); p = 0.025).

conclusionsThe AHI independently predicts in-hospital mortality in acute decompensated HF. This simple bed-side index could be useful in an emergency setting. (Arq Bras Cardiol. 2021; 116(1):77-86).

Indexed as

Heart FailureBrazilHemodynamicsHospital MortalityHumansPrognosisProspective StudiesReproducibility of Results

Identifiers

PMID33566969
PMCPMC8159496

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.