One-Year Mortality Prediction in Elderly Patients with Acute Heart Failure: Prognostic Contribution of the PROFUND Index and Serum Albumin

A. A. Kishta Kishta, M. M. Dolcet-Negre, M. J. Rivas-López, R. García Alonso, N. Muñoz Rivas, A. Guzmán Carreras, J. I. Molina Puente, M. Méndez Bailó

Older adults hospitalized with acute heart failure (AHF) often present with multimorbidity, frailty, and limited physiological reserve, making prognosis especially difficult in Internal Medicine. We evaluated the individual and combined prognostic value of the PROFUND index and serum albumin for 1-year mortality in a prospective multicenter cohort from the PROFUNDIC registry. Consecutive adults admitted with AHF or decompensated chronic heart failure, fulfilling ESC criteria and with NT-proBNP >1500 pg/mL, were included. Among 544 patients (mean age 85 years, 60% women), high PROFUND scores (>7) were found in 39% and hypoalbuminemia (≤3.5 g/dL) in 55%. Both independently predicted 1-year mortality, with the highest risk in patients with both high PROFUND and hypoalbuminemia. Their combination improved prognostic discrimination beyond the PROFUND index alone, supporting a simple and clinically useful strategy for early risk stratification.

Keywords: acute heart failure multimorbidity frailty serum albumin PROFUND index biological reserve prognostic models risk stratification internal medicine

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