CHF is a severe disease associated with a high risk of re-hospitalization and death. Most of prognostic scores focusing on long term follow up and are complex. On the opposite of acute heart failure scores, there is no real score that could be used by clinicians in order to analyzed the instability of HF and the risk of short term (6 months) re-hospitalization or death. We have analyzed the prognostic performance of several clinical biological and echocardiographic data in a prospective cohort of 1310 consecutive patients followed in our heart failure out patient hospital with systolic heart failure. Mean follow up was 52 months (6- 84 months). 3287 medical examinations pairs were finally analyzed. The events taken in account should be before the next planned out patient hospitalization (6 months). Our patients were mostly male (70%) and young (mean age 63 years old (15-96), 70% were in sinus rhythm, 10% demonstrate clinical congestion (lower limb oedema). Mean LVEF was 36 % (+- 10%). Mean BNP was 424 (+-200) pg/ml. HF aetiology was dilated in 50% and ischaemic in 40% of patients. During follow up 387 events (death or HF hospitalizations) followed out patient hospitalizations. In our cohort, heart rate (cut off 60 and 80 bpm), weight variation (decrease 2kg/ increase more than 4 kg between two consecutive out patient hospitalization), NYHA class variation (increase of more than 1 class), BNP absolute value (<200, 200-500 and > 500 pg/ml) and BNP variation (decrease more than 30%) were statistically associated with a risk of events. We have created a simple score (from 5 to 11 points) associating these different parameters classifying easily the patients.
Conclusion: A simple score could help clinicians to analyse the short term risk of death and hospitalization in a chronic setting in CHF patients. This could be useful in order to target high risk sub groups of patients that could benefit from an enhanced follow up or more aggressive management.