Abstract
Acute heart failure (AHF) is a common cause of hospitalization in the elderly and is associated with a high risk of rehospitalization and mortality. The EVEREST congestion score is considered a simple, feasible tool for assessing congestion and has potential prognostic value.
Objective: To evaluate the association between the EVEREST congestion score and mortality and rehospitalization after treatment for AHF.
Methods: A prospective study was conducted on 254 AHF patients admitted to the Vietnam National Heart Institute between August 2024 and February 2025, based on ESC 2021 criteria. The EVEREST score was assessed at admission and discharge. Outcomes were recorded at 30-day follow-up and included mortality and rehospitalization.
Results: In this prospective cohort of 254 patients hospitalized for acute heart failure, the EVEREST congestion score was used to evaluate clinical volume status at admission and discharge. The mean score at admission was 11.5 ± 4.0, indicating a high burden of congestion. Following standard therapy, the mean score decreased significantly to 1.7 ± 2.4 at discharge. Patients were stratified into groups based on their discharge EVEREST scores (0–2 vs. ≥3). Despite overall clinical improvement, 19.4% of patients had a score ≥3 at discharge, suggesting residual congestion. This group experienced significantly worse outcomes, including higher rates of in-hospital mortality (14.3%), 30-day mortality (8.2%), and 30-day rehospitalization (40.8%). In multivariate logistic regression, a discharge EVEREST score ≥3 was strongly associated with 30-day readmission (OR = 14.25; 95% CI: 4.45–64.00; p = 0.005).
Conclusion: The EVEREST congestion score is a simple prognostic tool with short-term predictive value and is suitable for clinical application in Vietnam.