170106 20260318155254.0 doi 10.1016/j.rceng.2025.502332 sideral 148611 ART-2025-148611 eng Campos Sáenz de Santamaría, A. Universidad de Zaragoza Multimodal analysis of congestion and prognostic utility of the VExUS protocol in hospitalized heart failure patients at a tertiary care hospital 2025 Background Multimodal assessment of congestion and venous excess ultrasound protocol (VExUS) play a determinant role for volume assessment and decongestive therapy in patients with acute heart failure (AHF). Methods Prospective, unicentrical and observational study in patients admitted for AHF at the Internal Medicine ward, designed to explore the prevalence, predictors and clinical outcomes of congestion (VExUS score) and the prevalence of congestive nephropathy. Results A total of 100 patients were included (mean age 86 ± 8 years were and 51% females). According to VExUS protocol, 49% exhibited moderate to severe congestion (VExUS 2-3). These patients were more clinical congested, showed higher concentrations of CA125 and microalbumin/creatinine ratio, and need greater doses of loop diuretics during hospitalization. The prevalence of congestive nephropathy on admission was 38%. Patients with VExUS score on admission ≥ 2 had a 2.5-fold increased risk for all-cause mortality and/or HF hospitalization at 1 year (OR 2.52, 95% CI 1.02–6.26, p = 0.046). In multivariable analysis elevated urea levels, larger inferior vena cava diameter and male gender, were identified as independent predictors on top of VExUS score for one-year mortality with an area under the curve for the final model of 0.740 (p < 0.001). Conclusions Moderate to severe congestion (VExUS grade 2-3) is associated with higher clinical congestion scores, greater need for diuretic treatment, and worse clinical outcomes, including increased mortality and rehospitalization rates in AHF. Furthermore, one-third of AHF showed congestion nephropathy a situation with clinical relevance that can influence decongestive treatments and final outcomes. Access copy available to the general public Unrestricted info:eu-repo/grantAgreement/ES/DGA/B07-23R info:eu-repo/grantAgreement/ES/DGA/T71-23D info:eu-repo/grantAgreement/ES/MCIU/PID2022-139143OA-I00 info:eu-repo/semantics/openAccess by https://creativecommons.org/licenses/by/4.0/deed.es info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Alcaine Otín, A. Universidad de Zaragoza (orcid)0000-0002-0166-2837 Crespo Aznarez, S. Josa Laorden, C. (orcid)0000-0002-8328-9836 Esterellas Sánchez, L. Sánchez Marteles, M. Universidad de Zaragoza (orcid)0000-0002-2338-7637 Garcés Horna, V. Universidad de Zaragoza Albines Fiestas, Z. Universidad de Zaragoza Giménez López, I. Rubio Gracia, J. Universidad de Zaragoza (orcid)0000-0002-4769-7154 1007 610 Universidad de Zaragoza Dpto. Medicina, Psiqu. y Derm. Area Medicina 5007 570 Universidad de Zaragoza Dpto. Informát.Ingenie.Sistms. Área Lenguajes y Sistemas Inf. 225, 7 (2025), 502332 [12 pp.] Revista Clínica Española (English Edition) 2254-8874 1216501 http://zaguan.unizar.es/record/170106/files/texto_completo.pdf Versión publicada 2101433 http://zaguan.unizar.es/record/170106/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:170106 articulos driver 2026-03-18-13:52:24 ARTICLE