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. 2025 May;114(5):609-615.
doi: 10.1007/s00392-024-02473-8. Epub 2024 Jun 3.

Prediction of recurrent heart failure hospitalizations and mortality using the echocardiographic Killip score

Yoav Granot #  1   2   3 , Yuval Meir #  4   5 , Michal Laufer Perl  4   5 , Assi Milwidsky  4   5 , Ben Sadeh  4   5 , Orly Ran Sapir  4   5   6 , Adva Trabelsi  4   5 , Shmuel Banai  4   5 , Yan Toplisky  4   5 , Ofer Havakuk  4   5
Affiliations

Prediction of recurrent heart failure hospitalizations and mortality using the echocardiographic Killip score

Yoav Granot et al. Clin Res Cardiol. 2025 May.

Abstract

Aim: Examine the performance of a simple echocardiographic "Killip score" (eKillip) in predicting heart failure (HF) hospitalizations and mortality after index event of decompensated HF hospitalization.

Methods: HF patients hospitalized at our facility between 03/2019-03/2021 who underwent an echocardiography during their index admission were included in this retrospective analysis. The cohort was divided into 4 classes of eKillip according to: stroke volume index (SVI) < 35ml/m2 > and E/E' ratio < 15 > . An eKillip Class I was defined as SVI ≥ 35ml/m2 and E/E' ≤ 15 and was used as reference.

Results: Included 751 patients, median age 78.1 (IQR 69.3-86) years, 59% men, left ventricular ejection fraction 45 (IQR 30-60)%, brain natriuretic peptide levels 634 (IQR 331-1222)pg/ml. Compared with eKillip Class I, a graded increase in the combined endpoint of 30-day mortality and rehospitalizations rates was noted: (Class II: HR 1.77, CI 0.95-3.33, p = 0.07; Class III: HR 1.94, CI 1.05-3.6, p = 0.034; Class IV: HR 2.9, CI 1.64-5.13, p < 0.001 respectively), which overall persisted after correction for clinical (Class II: HR 1.682, CI 0.9-3.15, p = 0.105; Class III: HR 2.104, CI 1.13-3.9, p = 0.019; Class IV: HR 2.74, CI 1.54-4.85, p = 0.001 respectively) or echocardiographic parameters (Class II: HR 1.92, CI 1.02-3.63, p = 0.045; Class III: HR 1.54, CI 0.81-2.95, p = 0.189; Class IV: HR 2.04, CI 1.1-3.76, p = 0.023 respectively). Specifically, the eKillip Class IV group comprised one-third of the patient population and persistently showed increased risk of 30-day HF hospitalizations or mortality following multivariate analysis.

Conclusion: A simple echocardiographic score can assist identifying high-risk decompensated HF patients for recurrent hospitalizations and mortality.

Keywords: Echocardiography; Heart failure readmissions; Killip score; Prediction.

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Conflict of interest statement

Declarations. Consent: The study was reviewed and approved by the Institutional Review Board with a waiver of informed consent. Conflict of interest: The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
A graded increased risk of 30-day heart failure hospitalization and mortality is shown with the use of the eKillip Class
See this image and copyright information in PMC

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