Background Recent evidence showed that new‐onset (de‐novo) acute heart failure (AHF) is a distinct type of AHF. However, the prognostic implication of gender on these patients remains unclear. Aims We aimed to investigate the impact of gender on both short and long‐term mortality outcomes after hospitalisation for de‐novo AHF. Methods We analysed the data of 721 patients with de‐novo AHF, who were enrolled in the HF survey in Israel between March and April 2003 and were followed until December 2014. Results Fifty‐four percent (N = 387) of the patients were men. In comparison to women, men patients were more likely to be younger, smokers, and with ischemic HF aetiology. At 30 days, mortality rates were higher in women (12% vs 7%, P = .013). Survival analysis showed that at 1 and 10 years the all‐cause mortality rates were significantly higher in women (28% vs 17%, and 78% vs 67%, 1 and 10 years, P < .001, respectively). Consistently, multivariable analysis showed that women had an independently 82% and 24% higher mortality risk at 1 and 10 years, respectively, (1‐year hazard ratio = 1.82; 95% confidence interval = 1.07 to 3.11, P = .03; 10‐year hazard ratio = 1.24; 95% confidence interval = 1.03 to 1.48, P = .02). Conclusions Amongst patients with de‐novo AHF, women had higher mortality rates compared with men. The observed gender‐related differences in de‐novo AHF patients highlight the need for further and deeper research in this field.

Background: Norton scoring system is used to assess frailty of hospitalized patients with various medical conditions. We aimed to evaluate whether admission Norton scoring system predicts adverse outcomes among heart failure patients. Methods: The study population comprised 4388 acute heart failure patients between the years 2008 and 2017. Patients were allocated to 3 groups according to their admission Norton score [( 15-low, 16-18intermediate, and !19-high)]. Primary outcome included all-cause mortality at 30, 90 days, and 1 year. Multivariate Cox proportional hazards regression modeling was used to assess the independent association between Norton score and mortality. Net reclassification improvement (NRI) analysis was used to asses Norton's additive predictive ability upon known prognostic factors. Results: Among 4388 study patients, 32% (n = 1611) had low Norton score, 28% (n = 1384) intermediate score, and 40% (n = 1900) high score. Kaplan-Meier analysis demonstrated significantly higher 30-day mortality among patients with a low Norton score as compared with those with intermediate or high score (2.6%, 6.3%, and 16.1%; log rank p < 0.001). A similar trend was noted at 90 days and 1 year. Multivariate analysis found Norton score to be an independent predictor of mortality with each one-point decrement associated with a significant 15% increased risk for 30-day mortality [HR = 1.15 (95% CI, 1.12-1.17) p < 0.001]. NRI analysis showed an improvement of 21.5% (95%CI 18.3-25.1%) predicting 1-year mortality. Conclusion: Our findings show that the admission Norton score is a powerful marker of short-and long-term mortality. These data suggest that the scale should be added as a risk stratification tool in this high-risk population.

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