ArticleInternational journal of general medicine2026
Composite Ultrasound Score Integrating VExUS Grading and Right Ventricular Function for Predicting 90-Day Heart Failure Rehospitalization: A Single-Center Retrospective Cohort Study.
Article in International journal of general medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: Systemic venous congestion and right ventricular (RV) dysfunction are important determinants of adverse outcomes in heart failure (HF). This study evaluated the prognostic value of a Composite Ultrasound Score integrating Venous Excess Ultrasound (VExUS) grading and multiparametric RV systolic function for predicting 90-day HF rehospitalization. Patients and Methods: This single-center retrospective cohort study included 712 patients hospitalized for HF who underwent pre-discharge echocardiographic assessment. The Composite Ultrasound Score ranged from 0 to 3 and combined VExUS-derived venous congestion with RV systolic dysfunction defined by TAPSE, RV S', and RV fractional area change. The primary endpoint was 90-day HF rehospitalization. Predictive performance was assessed using Cox regression, Harrell's C-index, time-dependent receiver operating characteristic analysis, and decision curve analysis. Results: During follow-up, 154 patients (21.6%) were rehospitalized. The Composite Ultrasound Score showed higher discrimination (C-index: 0.79; 95% CI: 0.75-0.83) than VExUS grading alone (0.74; P = 0.012), NT-proBNP (0.71; P < 0.001), or individual RV parameters. A score ≥2 identified a high-risk group with a 90-day event rate of 50.0% versus 8.3% in the low-risk group (log-rank P < 0.001). A high score remained independently associated with rehospitalization (adjusted HR: 2.85; 95% CI: 1.95-4.16; P < 0.001). The association was stronger in patients with chronic kidney disease (P for interaction = 0.038). Decision curve analysis suggested greater net benefit than single-parameter strategies. Conclusion: The Composite Ultrasound Score was independently associated with 90-day HF rehospitalization and showed moderate incremental prognostic value in this single-center retrospective cohort. It may serve as a promising adjunctive tool for pre-discharge risk stratification, particularly in patients with cardiorenal vulnerability. Prospective multicenter validation is required before routine clinical implementation.
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