doi:10.1016/j.medcli.2025.107327engCampos-Saenz de Santamaría, AmeliaGodos-Gómez, MarcCrespo-Aznarez, SilviaEsterellas-Sánchez, Laura KarlaSánchez-Marteles, MartaGarcés-Horna, VanesaGiménez-López, IgnacioRubio-Gracia, JorgeOutcome prediction in acute decompensated heart failure using the BAN-ADHF score across LVEF: Analysis in an internal medicine cohortART-2026-147967Background. The BAN-ADHF score integrates clinical, biomarker, and diuretic data to predict low diuretic efficiency and adverse events, offering a tool for individualized risk stratification. However, its performance in real-world settings remains understudied. No previous studies analyzed its usefulness across left ventricular ejection fraction (LVEF) phenotypes. Methods. Observational and retrospective study carried out at the Internal Medicine Ward of a tertiary hospital between 2018 and 2024. Patients were classified into low (<12) and high-risk (≥12) groups. The primary endpoint was all-cause mortality and/or rehospitalization for heart failure (HF) at 180 days. Results. A total of 472 patients were eligible. The mean age was 79.6 ± 9.4 years with 47.8% female and 64.6% of HF with preserved LVEF. Based on the BAN-ADHF score, 77.1% were categorized as “low-risk”, while 22.9% were classified as “high-risk”. High-risk patients were older (p = 0.019), more frequently male (p < 0.001), and had a higher comorbidity burden. At 180 days, the composite endpoint occurred in 30% of low-risk versus 64% of high-risk patients (p < 0.001). Mortality was 13.5% versus 41% (p < 0.001), and HF rehospitalization 42% versus 76% (p < 0.001). At one year, the combined outcome was 45% versus 76% (p < 0.001). High-risk status remained an independent predictor of adverse events (HR 2.8, 95% CI 2.1–3.8, p < 0.001). The BAN-ADHF score demonstrated acceptable predictive capacity (C-index 0.65). Conclusions. The BAN-ADHF score reliably identifies high-risk patients with a significantly greater incidence of adverse events, independently including readmission, mortality, and their composite at 180 days in a real-world cohort regardless LVEF. Its integration into routine care may help guide early therapeutic strategies and resource allocation.2026http://zaguan.unizar.es/record/16853310.1016/j.medcli.2025.107327http://zaguan.unizar.es/record/168533oai:zaguan.unizar.es:168533info:eu-repo/grantAgreement/ES/DGA/B07-23Rinfo:eu-repo/grantAgreement/ES/DGA/T71-23Dinfo:eu-repo/grantAgreement/ES/MCIU/PID2022-139143OA-I00Medicina clinica 166, 2 (2026), 107327by-nc-ndhttps://creativecommons.org/licenses/by-nc-nd/4.0/deed.esinfo:eu-repo/semantics/embargoedAccess