AIM To explore the value of hemoglobin (Hb) and serum albumin (ALB) in evaluating the long-term prognosis of elderly patients with chronic heart failure.
METHODS The clinical data of 200 elderly patients with chronic heart failure in our hospital from February 2018 to April 2019 were collected, and the levels of hemoglobin and serum albumin were detected. The patients after discharge were followed up for 3 years, and were divided into survival group (n=142) and death group (n=58) according to whether the follow-up patients died. Logistic multivariate regression was used to analyze the independent risk factors of patients' death, and the optimal cut-off points of Hb and ALB levels were determined by characteristic curve (ROC). A nomogram prediction model was established and verified according to the independent risk factors of patients' prognosis.
RESULTS Compared with the survival group, Compared with the survival group, the proportion of previous myocardial infarction in the death group was significantly higher (P<0.05); High sensitity C-reactive protein (hs-CRP), N-terminal pro brain natriuretic peptise (NT-proBNP) and cardiac troponin I (CTnI) increased significantly (P<0.05) and the levels of serum Hb, ALB and left ventricular ejection fraction (LVEF) decreased significantly (P<0.01). Multivariate Logistic regression analysis showed that myocardial infarction, elevated serum hs-CRP, elevated serum NT-proBNP, decreased serum Hb, decreased serum ALB and decreased LVEF were independent risk factors for death. The area under the ROC curve for Hb to predict the death of patients is 0.753, the cut-off point is 117.8g/L, its sensitivity is 72.00%, and its specificity is 75.20%. The area under ROC curve of ALB for predicting patient death is 0.878, the cutoff point is 34.70 g/L, and its sensitivity is 86.00% and specificity is 79.20%. According to the independent risk factors of prognosis, the nomogram model was constructed, and its consistency index (C-index) was 0.768 (95%CI: 0.716~0.820), and its ROC curve AUC was 0.840 (95%CI: 0.791~0.889), which had good discrimination. The evaluation results of Calibration curve indicate that the model has good consistency.
CONCLUSION Low Hb and ALB levels are independent risk factors for the prognosis of elderly patients with chronic heart failure, and have good predictive value for the prognosis of these patients.
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