Research progress on the predictive value of the AHEAD Score for heart failure prognosis
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摘要: 心力衰竭(心衰)是重大的公共卫生问题，其相关的预后直接关系到患者再住院率和病死率。心衰风险预测模型可以有效评估患者的预后，以此调整治疗方案有助于稳定病情和改善生活质量。目前许多心衰风险预测模型因变量过多或过于复杂而使其临床应用受限。AHEAD评分是一个基于合并症分析的简单评分系统，其临床操作性较强，包含心房颤动(房颤)、贫血、年龄、血肌酐、糖尿病5项指标。AHEAD评分对评估心衰患者远期预后具有重要预测价值，可以有效预测患者的病死率，但也存在一定局限性，并且在某些人群中表现不佳。近年来的一些研究表明尿酸、脑钠肽等指标的纳入或许能提高其预测效能。未来需要更多的临床研究来验证AHEAD评分的可行性，并进一步探究AHEAD评分对心衰再住院率的预测价值。Abstract: Heart failure(HF) is a major public health concern, with its prognosis directly impacting patient readmission rates and mortality. HF risk prediction models can effectively evaluate patient outcomes, enabling tailored treatment strategies that help stabilize the condition and improve quality of life. However, many existing HF risk models are limited in clinical application due to their complexity or the large number of variables involved. The AHEAD score, a simple scoring system based on comorbidity analysis, offers greater clinical feasibility. It includes five key indicators: atrial fibrillation, anemia, age, serum creatinine, and diabetes. The AHEAD score has demonstrated significant predictive value for long-term outcomes in HF patients, effectively forecasting mortality. Nonetheless, it has certain limitations and may underperform in specific populations. Recent studies suggest that incorporating markers such as uric acid and BNP could enhance its predictive accuracy. Further clinical studies are needed to validate the feasibility of the AHEAD score and to explore its potential in predicting HF readmission rates.
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Key words:
- heart failure /
- AHEAD score /
- risk prediction model /
- predictive value /
- prognosis
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表 1 AHEAD评分的临床应用
Table 1. Clinical application of AHEAD score
作者 发表时间 研究类型 研究对象 纳入数/例 时间跨度 AUC Spinar等 2016年 前瞻性多中心队列研究 急性心衰患者 5 846 90个月 开发队列：0.748，
验证队列：0.631Chen等 2017年 前瞻性单中心队列研究 急性心衰患者 2 143 (22±14)个月 Ruiz-Ruiz等 2019年 前瞻性多中心队列研究 急性心衰患者 180 1年 开发队列：0.68，
验证队列：0.58谢卫星等 2022年 回顾性调查研究 慢性心衰患者 115 180 d 0.718 洪蕾等 2024年 前瞻性单中心队列研究 慢性心衰患者 114 (35.80±5.82)个月 0.679 
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