scholarly journals Discriminatory accuracy of the SOFA score for determining clinical decompensation in patients presenting with COVID-19

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
N Krepostman ◽  
M Collins ◽  
K Merchant ◽  
S De Sirkar ◽  
L Chan ◽  
...  
Keyword(s):  
Sofa Score ◽  
Medical Center ◽  
Case Fatality ◽  
Composite Endpoint ◽  
Study Endpoint ◽  
Severe Illness ◽  
Urban Hospital ◽  
Hospital System ◽  
Entire Cohort ◽  
Discriminatory Accuracy

Abstract Introduction While the global dissemination of vaccines targeting the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in a decline in the incidence of infections, the case fatality rates have remained relative stable. A major objective of managing hospitalized patients with documented or suspected COVID-19 infection is the rapid identification of features associated with severe illness using readily available laboratory tests and clinical tools. The sequential organ failure assessment (SOFA) score is a validated tool to facilitate the identification of patients at risk of dying from sepsis. Purpose The aim of this study was to assess the discriminatory accuracy of the SOFA score in predicting clinical decompensation in patients hospitalized with COVID-19 infection. Methods We conducted a retrospective analysis at a three-hospital health system, comprised of one tertiary and two community hospitals, located in the Chicago metropolitan area. All patients had positive SARS-CoV-2 testing and were hospitalized for COVID-19 infection. The primary outcome was clinical decompensation, defined as the composite endpoint of death, ICU admission, or need for intubation. We utilized the most abnormal laboratory values observed during the admission to calculate the SOFA score. Receiver Operating Curves (ROC) were then constructed to determine the sensitivity and specificity of SOFA scores. Results Between March 1st and May 31st 2020, 1029 patients were included in our analysis with 367 patients meeting the study endpoint. The median SOFA score was 2.0 IQR (Q1, Q3 1,4) for the entire cohort. Patients who had in-hospital mortality had a median SOFA score of 4.0 (Q1,Q3 3,7). In patients that met the primary composite endpoint, the median SOFA score was 3.0, IQR (Q1, Q3 2,6). The ROC was 0.776 (95% CI 0.746–0.806, p<0.01). Conclusion The SOFA score demonstrates strong discriminatory accuracy for prediction of clinical decompensation in patients presenting with COVID-19 at our urban hospital system. FUNDunding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Loyola University Medical Center

scholarly journals COVID-19 in Adults With Hypertrophic Cardiomyopathy

2021 ◽  
Vol 8 ◽  
Author(s):  
Milla E. Arabadjian ◽  
Maria C. Reuter ◽  
Alexandra Stepanovic ◽  
Mark V. Sherrid ◽  
Daniele Massera
Keyword(s):  
Atrial Fibrillation ◽  
Hypertrophic Cardiomyopathy ◽  
High Risk ◽  
Acute Decompensated Heart Failure ◽  
Case Fatality ◽  
Antibody Test ◽  
High Risk Group ◽  
Urban Hospital ◽  
Hospital System ◽  
Obstructive Sleep

Background: Individuals with cardiovascular disease are considered high risk for severe COVID-19. However, the clinical impact of COVID-19 in patients with hypertrophic cardiomyopathy (HCM) is unknown. The purpose of this study was to describe the clinical course and outcomes of COVID-19 in patients with HCM.Methods: This retrospective observational study included adults with HCM and positive PCR/antibody test for SARS-CoV-2 at a large urban hospital system in the New York from January, 2020 to January, 2021.Results: Seventy individuals were included, with a mean (SD) age of 60.1 (15.1) years, 39 (55.7%) of whom were male, and 42 (60%) white. Forty-five (65.3%) patients had obstructive HCM. Hypertension and obesity (BMI ≥ 30) were present in 45 (64.3%) and 37 (52.9%) patients, and the prevalence of atrial fibrillation, obstructive sleep apnea and diabetes was high. Common symptoms of COVID-19 were fever, cough, shortness of breath and fatigue, affecting 33 (47.1%), 33 (47.1%), 28 (40.0%), and 28 (40.0%) patients, respectively. Fourteen (20%) patients were hospitalized. The majority (45 [64.3%] patients) recovered without intervention. Two patients had non-fatal pulmonary embolisms, 1 had atrial fibrillation requiring electrical cardioversion and 1 had acute decompensated heart failure. Three (4.3%) patients required mechanical ventilation, two of whom died (case fatality rate 2.9%). A total of 15 (21.4%) patients were asymptomatic.Conclusions: Our data suggest that in this diverse and high-risk group of patients with HCM, established risk factors for severe COVID-19, such as obesity, may be more important drivers of morbidity and mortality than the presence of HCM alone.

scholarly journals Epidemiological, Virological and Serological Features of Coronavirus Disease 2019 (COVID-19) Cases in People Living With Human Immunodeficiency Virus in Wuhan: A Population-based Cohort Study

2020 ◽  
Author(s):  
Jiao Huang ◽  
Nianhua Xie ◽  
Xuejiao Hu ◽  
Han Yan ◽  
Jie Ding ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Cohort Study ◽  
Demographic Data ◽  
Case Fatality ◽  
Population Based ◽  
Severe Illness ◽  
Viral Loads ◽  
Viral Shedding ◽  
Signal Value ◽  
Immunodeficiency Virus

Abstract Background We aimed to describe the epidemiological, virological, and serological features of coronavirus disease 2019 (COVID-19) cases in people living with human immunodeficiency virus (HIV; PLWH). Methods This population-based cohort study identified all COVID-19 cases among all PLWH in Wuhan, China, by 16 April 2020. The epidemiological, virological, and serological features were analyzed based on the demographic data, temporal profile of nucleic acid test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the disease, and SARS-CoV-2–specific immunoglobin (Ig) M and G after recovery. Results From 1 January to 16 April 2020, 35 of 6001 PLWH experienced COVID-19, with a cumulative incidence of COVID-19 of 0.58% (95% confidence interval [CI], .42–.81%). Among the COVID-19 cases, 15 (42.86) had severe illness, with 2 deaths. The incidence, case-severity, and case-fatality rates of COVID-19 in PLWH were comparable to those in the entire population in Wuhan. There were 197 PLWH who had discontinued combination antiretroviral therapy (cART), 4 of whom experienced COVID-19. Risk factors for COVID-19 were age ≥50 years old and cART discontinuation. The median duration of SARS-CoV-2 viral shedding among confirmed COVID-19 cases in PLWH was 30 days (interquartile range, 20–46). Cases with high HIV viral loads (≥20 copies/mL) had lower IgM and IgG levels than those with low HIV viral loads (<20 copies/ml; median signal value divided by the cutoff value [S/CO] for IgM, 0.03 vs 0.11, respectively [P < .001]; median S/CO for IgG, 10.16 vs 17.04, respectively [P = .069]). Conclusions Efforts are needed to maintain the persistent supply of antiretroviral treatment to elderly PLWH aged 50 years or above during the COVID-19 epidemic. The coinfection of HIV and SARS-CoV-2 might change the progression and prognosis of COVID-19 patients in PLWH.

scholarly journals Survival Analysis of 3 Different Age Groups and Prognostic Factors among 402 Patients with Skeletal High-Grade Osteosarcoma. Real World Data from a Single Tertiary Sarcoma Center

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 486
Author(s):  
Richard E. Evenhuis ◽  
Ibtissam Acem ◽  
Anja J. Rueten-Budde ◽  
Diederik S. A. Karis ◽  
Marta Fiocco ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Medical Center ◽  
Age Groups ◽  
High Grade ◽  
Real World Data ◽  
Poor Overall Survival ◽  
Histopathological Response ◽  
Curative Intent ◽  
Entire Cohort ◽  
High Grade Osteosarcoma

Age is a known prognostic factor for many sarcoma subtypes, however in the literature there are limited data on the different risk profiles of different age groups for osteosarcoma survival. This study aims to provide an overview of survival in patients with high-grade osteosarcoma in different age groups and prognostic variables for survival and local control among the entire cohort. In this single center retrospective cohort study, 402 patients with skeletal high-grade osteosarcoma were diagnosed and treated with curative intent between 1978 and 2017 at the Leiden University Medical Center (LUMC). Prognostic factors for survival were analyzed using a Cox proportional hazard model. In this study poor overall survival (OS) and event-free survival (EFS) were associated with increasing age. Age groups, tumor size, poor histopathological response, distant metastasis (DM) at presentation and local recurrence (LR) were important independent prognostic factors influencing OS and EFS. Differences in outcome among different age groups can be partially explained by patient and treatment characteristics.

scholarly journals 1787. The Effects of a Systemwide Diagnostic Stewardship Change on West Nile Virus Disease Ordering Practices

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S658-S658
Author(s):  
Andrew H Karaba ◽  
Paul W Blair ◽  
Kevin M Martin ◽  
Mustapha O Saheed ◽  
Karen C Carroll ◽  
...  
Keyword(s):  
West Nile Virus ◽  
Virus Disease ◽  
Case Fatality ◽  
Cost Savings ◽  
Primary Objective ◽  
Neurological Deficits ◽  
West Nile ◽  
Hospital System ◽  
Elisa Testing ◽  
Before And After

Abstract Background Neuroinvasive West Nile Virus (WNV) often leads to prolonged neurological deficits and carries a high case fatality rate. The CSF IgM (MAC-ELISA) is preferred over the CSF nucleic acid-based test (NAAT) by the CDC due to its higher sensitivity. However, our hospital system was observed to have an over-utilization of NAAT testing compared with MAC-ELISA testing. The primary objective was to compare the number of MAC-ELISA and NAAT WNV tests ordered before and after a diagnostic stewardship intervention. The secondary objectives were to determine whether this change to lead to any cost savings and increased detection of probable cases of WNV-ND. Methods In an effort to increase the use of the MAC-ELISA and to decrease unnecessary NAAT testing, the NAAT test was removed in April 2018 from the test menu in the electronic health record of a health system comprising five hospitals in the Maryland and Washington, D.C. area. NAAT testing remained possible via a paper order form. This study was a retrospective review of WNV testing done on CSF samples from July 2016 through December 2018. The seasonal and yearly number of total tests, positive tests, and total costs were determined from the period of July, 2017 to April, 2018 and were compared with May, 2018 to January, 2019. A paired t-test was performed to evaluate for differences in total testing, total positives, and total costs during non-winter months before and after the intervention. Results A total of 12.59 MAC-ELISA tests/month (95% CI: 10.29, 14.89) increased to 41 tests/month (95% CI: 34.35, 47.65) which was significantly different (P < 0.001). In contrast, there were 46.23 NAAT tests/month (95% CI: 39.55, 52.91) which decreased to 0 NAAT tests/month after the intervention (P < 0.001). This resulted in an average decrease in WNV test spending from $7200 per month to $471 per month (P < 0.001). Preceding the intervention in test ordering, 0.23% of WNV CSF tests were positive (NAAT+MAC-ELISA) while 2.44% WNV CSF tests were positive after the intervention (P = 0.03). Conclusion Elimination of electronic WNV NAAT ordering is an effective way of decreasing inappropriate WNV NAAT testing, decreasing associated costs, and may lead to improved diagnosis of WNV-ND. Disclosures All authors: No reported disclosures.

Surge capacity and capability of intensive care units across a large healthcare system: An operational blueprint for regional integration

2021 ◽  
Vol 16 (3) ◽  
pp. 179-192
Author(s):  
Abhijit Duggal, MD, MPH, MSc ◽  
Erica Orsini, MD ◽  
Eduardo Mireles-Cabodevila, MD ◽  
Sudhir Krishnan, MD ◽  
Prabalini Rajendram, MD ◽  
...  
Keyword(s):  
Resource Allocation ◽  
Intensive Care ◽  
Healthcare System ◽  
Regional Integration ◽  
Medical Center ◽  
Academic Medical Center ◽  
Healthcare Services ◽  
Surge Capacity ◽  
Hospital System ◽  
The Individual

Objective: Many hospitals were unprepared for the surge of patients associated with the spread of coronavirus disease 2019 (COVID-19) pandemic. We describe the processes to develop and implement a surge plan framework for resource allocation, staffing, and standardized management in response to the COVID-19 pandemic across a large integrated regional healthcare system.Setting: A large academic medical center in the Cleveland metropolitan area, with a network of 10 regional hospitals throughout Northeastern Ohio with a daily capacity of more than 500 intensive care unit (ICU) beds.Results: At the beginning of the pandemic, an equitable delivery of healthcare services across the healthcare system was developed. This distribution of resources was implemented with the potential needs and resources of the individual ICUs in mind, and epidemiologic predictions of virus transmissibility. We describe the processes to develop and implement a surge plan framework for resource allocation, staffing, and standardized management in response to the COVID-19 pandemic across a large integrated regional healthcare system. We also describe an additional level of surge capacity, which is available to well-integrated institutions called “extension of capacity.” This refers to the ability to immediately have access to the beds and resources within a hospital system with minimal administrative burden.Conclusions: Large integrated hospital systems may have an advantage over individual hospitals because they can shift supplies among regional partners, which may lead to faster mobilization of resources, rather than depending on local and national governments. The pandemic response of our healthcare system highlights these benefits.

Abstract 16010: Congestive Heart Failure and Coronavirus Disease 2019 Illness Severity

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Max Ruge ◽  
Joanne Michelle D Gomez ◽  
Gatha G Nair ◽  
Setri Fugar ◽  
Jeanne du Fay de Lavallaz ◽  
...  
Keyword(s):  
Heart Failure ◽  
At Risk ◽  
Congestive Heart Failure ◽  
Case Fatality ◽  
Severity Of Illness ◽  
Severe Infection ◽  
Severe Illness ◽  
Increased Risk ◽  
History Of ◽  
Male Sex

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has killed hundreds of thousands worldwide. Those with cardiovascular disease represent a vulnerable population with higher risk for contracting COVID-19 and worse prognosis with higher case fatality rates. Congestive heart failure (CHF) may lead to worsening COVID-19 symptoms. However, it is unclear if CHF is an independent risk factor for severe COVID-19 infection or if other accompanying comorbidities are responsible for the increased risk. Methods: From March to June 2020, data was obtained from adult patients diagnosed with COVID-19 infection who were admitted in the Rush University System for Health (RUSH) in Illinois. Heart failure patients, determined by ICD code assignments extracted from the electronic medical records, were identified. Multivariable logistic regression was performed between predictor variables and a composite outcome of severe infection consisting of Intensive Care Unit (ICU) admission, intubation, or in-hospital mortality. Results: In this cohort (n=1136), CHF [odds ratio (OR) 1.02] alone did not predict a more severe illness. Prior myocardial infarction [(MI), OR 3.55], history of atrial fibrillation [(AF), OR 2.14], and male sex (OR 1.55) were all significantly (p<0.001) associated with more severe COVID-19 illness course when controlling for CHF (Figure 1). In the 178 CHF patients, more advanced age (68.8 years vs. 63.8 years; p<0.05) and female sex (54.5% vs. 39.1%; p<0.05) were associated with increased severity of illness. Conclusions: Prior MI, history of AF, and male sex predicted more severe COVID-19 illness course in our cohort, but pre-existing heart failure alone did not. However, CHF patients who are females and older in age are at risk for severe infection. These findings help clinicians identify patients with comorbidities early at risk for severe COVID-19 illness.

scholarly journals HIV-1 Infection Does Not Change Disease Course or Inflammatory Pattern of SARS-CoV-2-Infected Patients Presenting at a Large Urban Medical Center in New York City

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Justin Laracy ◽  
Jason Zucker ◽  
Delivette Castor ◽  
Donald J McMahon ◽  
Tai Wei Guo ◽  
...  
Keyword(s):  
New York ◽  
Mechanical Ventilation ◽  
Medical Center ◽  
Inflammatory Marker ◽  
Admission Rate ◽  
Ventilation Rate ◽  
Urban Hospital ◽  
Hiv Diagnosis ◽  
Significant Difference ◽  
Study Population

Abstract Background The clinical impact of coronavirus disease 2019 (COVID-19) among people with HIV (PWH) remains unclear. In this retrospective cohort study of COVID-19, we compared clinical outcomes and laboratory parameters among PWH and controls. Methods Sixty-eight PWH diagnosed with COVID-19 were matched 1:4 to patients without known HIV diagnosis, drawn from a study population of all patients who were diagnosed with COVID-19 at an academic urban hospital. The primary outcome was death/discharge to hospice within 30 days of hospital presentation. Results PWH were more likely to be admitted from the emergency department than patients without HIV (91% vs 71%; P = .001). We observed no statistically significant difference between admitted PWH and patients without HIV in terms of 30-day mortality rate (19% vs 13%, respectively) or mechanical ventilation rate (18% vs 20%, respectively). PWH had higher erythrocyte sedimentation rates than controls on admission but did not differ in other inflammatory marker levels or nasopharyngeal/oropharyngeal severe acute respiratory syndrome coronavirus 2 viral load estimated by reverse transcriptase polymerase chain reaction cycle thresholds. Conclusions HIV infection status was associated with a higher admission rate; however, among hospitalized patients, PWH did not differ from HIV-uninfected controls by rate of mechanical ventilation or death/discharge to hospice.

scholarly journals The Predictive Value of Myoglobin for COVID-19-Related Adverse Outcomes: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Chaoqun Ma ◽  
Dingyuan Tu ◽  
Jiawei Gu ◽  
Qiang Xu ◽  
Pan Hou ◽  
...  
Keyword(s):  
Troponin I ◽  
Meta Analysis ◽  
Severe Disease ◽  
Cardiac Injury ◽  
Case Fatality ◽  
Adverse Outcomes ◽  
Cardiac Biomarkers ◽  
Severe Illness ◽  
Poor Outcomes ◽  
Meta Analyses

Objective: Cardiac injury is detected in numerous patients with coronavirus disease 2019 (COVID-19) and has been demonstrated to be closely related to poor outcomes. However, an optimal cardiac biomarker for predicting COVID-19 prognosis has not been identified.Methods: The PubMed, Web of Science, and Embase databases were searched for published articles between December 1, 2019 and September 8, 2021. Eligible studies that examined the anomalies of different cardiac biomarkers in patients with COVID-19 were included. The prevalence and odds ratios (ORs) were extracted. Summary estimates and the corresponding 95% confidence intervals (95% CIs) were obtained through meta-analyses.Results: A total of 63 studies, with 64,319 patients with COVID-19, were enrolled in this meta-analysis. The prevalence of elevated cardiac troponin I (cTnI) and myoglobin (Mb) in the general population with COVID-19 was 22.9 (19–27%) and 13.5% (10.6–16.4%), respectively. However, the presence of elevated Mb was more common than elevated cTnI in patients with severe COVID-19 [37.7 (23.3–52.1%) vs.30.7% (24.7–37.1%)]. Moreover, compared with cTnI, the elevation of Mb also demonstrated tendency of higher correlation with case-severity rate (Mb, r = 13.9 vs. cTnI, r = 3.93) and case-fatality rate (Mb, r = 15.42 vs. cTnI, r = 3.04). Notably, elevated Mb level was also associated with higher odds of severe illness [Mb, OR = 13.75 (10.2–18.54) vs. cTnI, OR = 7.06 (3.94–12.65)] and mortality [Mb, OR = 13.49 (9.3–19.58) vs. cTnI, OR = 7.75 (4.4–13.66)] than cTnI.Conclusions: Patients with COVID-19 and elevated Mb levels are at significantly higher risk of severe disease and mortality. Elevation of Mb may serve as a marker for predicting COVID-19-related adverse outcomes.Prospero Registration Number:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020175133, CRD42020175133.

Abstract WP363: Journey of a Five-Hospital System to Primary Stroke Center Certification

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Deb Motz ◽  
Dicky Huey ◽  
Tracy Moore ◽  
Byron Freemyer ◽  
Tommye Austin
Keyword(s):  
Administrative Support ◽  
Medical Center ◽  
Academic Medical Center ◽  
Stroke Care ◽  
Multidisciplinary Teams ◽  
Hospital System ◽  
Order Sets ◽  
Primary Stroke Center ◽  
Stroke Center ◽  
Evidenced Based

Background: In 2008, a city with a population of over one million people had no organized stroke care or Certified Primary Stroke Centers. Patients presenting with stroke symptoms had inconsistent neurology coverage and little or no access to rtPA. The purpose is to describe steps taken for five acute-care hospitals (with one CMS provider number) to become Primary Stroke Certified. Methods: The journey began with administrative support and a commitment to provide the resources for a successful program. To oversee development, a Medical Director and Stroke Coordinator were appointed. To bridge the gap in available specialty physicians, partnerships were formed with a telemedicine group to provide emergency treatment and an academic medical center to augment the neurology and neuro-surgical coverage. Multidisciplinary teams met monthly in each facility. Representatives from each team formed a regional committee and an education council was created to share best practices and assure consistency across the system. Evidenced based order sets were developed using clinical practice guidelines. The Medical Executive Committee at each facility and ultimately the Medical Executive Board endorsed the order sets and mandated their use. Each facility chose the appropriate unit to cohort the stroke patients which encouraged expertise in care. Results: This journey resulted in a high functioning system of care. Baptist Health System became Joint Commission Certified in all five locations (May 2009). We were awarded the Get with the Guidelines Bronze Award (September 2010), the Silver Plus Award (July 2011) and the Gold Plus Award (July 2012). In addition, we were the first in Texas to achieve the Target Stroke Honor Roll (Q3 2011) and have maintained this status for eight consecutive quarters. Conclusion: In conclusion, administrative support is imperative to the success of a stroke program. Leadership, partnerships, committees, councils and staff involvement from the start drove the team to a successful certification process with outstanding outcomes. The stroke committees continue to meet monthly to analyze performance measures, identify opportunities for improvement and execute action plans.

Abstract 14200: Prognostic Significance of Dipstick Proteinuria in Heart Failure With Preserved Ejection Fraction - Insight From the Pursuit-hfpef Registry

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Bolrathanak Oeun ◽  
Shungo Hikoso ◽  
Daisaku Nakatani ◽  
Hiroya Mizuno ◽  
Tetsuhisa Kitamura ◽  
...  
Keyword(s):  
Heart Failure ◽  
Prognostic Marker ◽  
Composite Endpoint ◽  
Study Endpoint ◽  
Dipstick Test ◽  
Urine Dipstick ◽  
All Cause Mortality ◽  
Urine Dipstick Test ◽  
Group 2 ◽  
Group 1

Introduction: Although albuminuria evaluated with urinary albumin-to-creatinine ratio (UACR) was shown to be a prognostic marker in patients with heart failure, measurement of UACR needs special equipment. Urine dipstick test is a simple and convenient method which is available even in community-based health care. Hypothesis: We hypothesized that dipstick proteinuria might be a prognosticator in HFpEF. Methods: We assessed 738 discharged-alive patients in the PURSUIT-HFpEF registry. Patients received urine dipstick test, and were divided into 2 groups according to the absence or presence of proteinuria (proteinuria trace or more). The study endpoint was a composite of all-cause mortality and HF hospitalization. Results: Median age was 82 years and 410 patients were female. Four hundred thirty-four patients: proteinuria-(group 1); 304 patients: proteinuria+(group 2). Group 2 was more likely male with higher frequency of diabetes, previous myocardial infarction and chronic kidney disease, but less likely to take ACEIs than group 1. Higher blood pressure, NT-proBNP, creatinine, E/e’, TRPG, and LV mass index were observed in group 2 than group 1. The composite endpoint and HF hospitalization occurred more often in group 2 than group 1 (HR: 1.43, 95%CI: 1.09-1.87, log-rank P=0.009; HR: 1.57, 95%CI: 1.14-2.15, log-rank P=0.005, respectively); but all-cause mortality did not (HR: 1.40, 95%CI: 0.92-2.11, log-rank P=0.113). Multivariable Cox regression adjusting for NT-proBNP, eGFR and other major confounding factors showed that proteinuria was associated with the composite endpoint (HR: 1.42, 95% CI: 1.05-1.94, P=0.026), and HF hospitalization (HR: 1.51, 95%CI: 1.04-2.18, P=0.030), but not with all-cause mortality (HR: 1.51, 95%CI:0.94-2.43, P=0.092). Conclusions: Dipstick proteinuria may be a prognostic marker in patients with HFpEF. Evaluation of proteinuria by urine dipstick test may be a simple but useful method for risk stratification in HFpEF.

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