ArticleInternal and emergency medicine2026
Prognostic performance of the BAN-ADHF score in acute decompensated heart failure: a sub-analysis of the Spanish Heart Failure Registry (RICA).
Article in Internal and emergency 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
The BAN-ADHF score is a recently developed measure designed to predict low diuretic efficiency and adverse outcomes using eight simple routinely available clinical and laboratory variables. However, its performance in real-world settings remains understudied. This is a retrospective analysis using data from the Spanish Heart Failure Registry (RICA), a nationwide, prospective cohort of patients admitted for ADHF to internal medicine departments. Only patients with complete data to calculate the BAN-ADHF score were included. Patients were classified into low BAN-ADHF (< 12) and high BAN-ADHF (≥ 12) groups. The primary endpoint was all-cause mortality. Secondary endpoints included the composite of mortality and/or heart failure (HF) readmission and length of hospital stay. A total of 2110 were eligible. High BAN-ADHF patients (17.5%) were older, with a higher burden of comorbidities, worse functional class and a higher proportion of reduced left ventricular ejection fraction (LVEF). Additionally, high BAN-ADHF patients showed lower hemoglobin, sodium, and estimated glomerular filtration rate, together with higher levels of creatinine, potassium, CA125, and NT-proBNP. After a median follow-up of 363 days, all-cause mortality occurred in 30.3% of patients, predominantly in the high BAN-ADHF group (HR 1.75, 95% CI 1.46-2.08, p = 0.001). The composite endpoint occurred in 44.9% of patients and was more frequent in the high BAN-ADHF group (HR 1.47, 95% CI 1.24-1.76, p = 0.001). Moreover, the BAN-ADHF score was independently associated with longer hospital stays (p = 0.001). No interaction was found between LVEF and the BAN-ADHF categories. The BAN-ADHF score is a valuable prognostic tool for identifying ADHF patients at greater risk of mortality, rehospitalization, and longer hospitalization in a real-world setting. Its integration into routine care may help guide early therapeutic strategies and resource allocation.
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