Medicina clinica · 2026
Prognostic value of prealbumin and PROFUND index in patients with acute heart failure: Results from the RICA Registry.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Kishta Kishta Aladin Abdelhady, Méndez Bailón Manuel, Molina Puente Juan Igor, Formiga Pérez Francesc, Arévalo Lorido José Carlos, Llacer Iborra Pau, Casado Cerrada Jesús, Montero Pérez-Barquero Manuel
Аннотация
INTRODUCTION: Acute heart failure (AHF) is a leading cause of hospitalization among older adults, associated with high mortality and frequent readmissions. Prealbumin has been proposed as a marker of nutritional status and systemic inflammation, while the PROFUND index stratifies long-term risk in multimorbid patients. However, the combined prognostic utility of both tools in AHF remains poorly defined.
OBJECTIVE: To assess the individual and combined prognostic value of prealbumin levels and the PROFUND index in predicting 12-month mortality and hospital readmissions in elderly patients admitted for AHF.
METHODS: We conducted a retrospective, observational study using data from the National RICA Registry. Patients aged≥65 years hospitalized for AHF with available prealbumin levels and PROFUND index at admission were included. Associations with 12-month mortality and readmission rates were analyzed using multivariate models, ROC curve analysis, and Kaplan-Meier survival estimates.
RESULTS: A total of 609 patients were included (median age 80 years, 61% female). Low prealbumin levels (<18mg/dL) were observed in 51% of patients. One-year mortality was significantly higher in the low prealbumin group (55.8 vs. 38.0%; p<0.001). The PROFUND index showed a progressive association with mortality risk (p<0.001). The combination of low prealbumin and high PROFUND index improved the prediction of all-cause mortality (AUC=0.685), but did not significantly impact readmission risk.
CONCLUSIONS: Both prealbumin levels and the PROFUND index independently predict mortality in elderly patients hospitalized for AHF. Their combined assessment may enhance risk stratification, identifying vulnerable subgroups with higher short-term mortality. Their predictive value for hospital readmissions appears limited.
OBJECTIVE: To assess the individual and combined prognostic value of prealbumin levels and the PROFUND index in predicting 12-month mortality and hospital readmissions in elderly patients admitted for AHF.
METHODS: We conducted a retrospective, observational study using data from the National RICA Registry. Patients aged≥65 years hospitalized for AHF with available prealbumin levels and PROFUND index at admission were included. Associations with 12-month mortality and readmission rates were analyzed using multivariate models, ROC curve analysis, and Kaplan-Meier survival estimates.
RESULTS: A total of 609 patients were included (median age 80 years, 61% female). Low prealbumin levels (<18mg/dL) were observed in 51% of patients. One-year mortality was significantly higher in the low prealbumin group (55.8 vs. 38.0%; p<0.001). The PROFUND index showed a progressive association with mortality risk (p<0.001). The combination of low prealbumin and high PROFUND index improved the prediction of all-cause mortality (AUC=0.685), but did not significantly impact readmission risk.
CONCLUSIONS: Both prealbumin levels and the PROFUND index independently predict mortality in elderly patients hospitalized for AHF. Their combined assessment may enhance risk stratification, identifying vulnerable subgroups with higher short-term mortality. Their predictive value for hospital readmissions appears limited.