through the

Introduction: The increase in life expectancy and the aging of the population are associated with an increase in the prevalence of chronic diseases. Comorbidities have an important impact on prognosis and functional capacity leading to a progressive deterioration of autonomy and quality of life and an increase in demand for medical care. Establishment of an accurate prognosis constitutes one of the primary objectives in healthcare. An accurate estimate of prognosis helps clinicians make diagnostic and therapeutic decisions, prevent iatrogenesis, and consider palliative care strategy as needed. It also allows the patient and family members to organize their preferences and priorities. Objective: To evaluate the PROFUND scale in patients with heart failure from a prognostic point of view. Methods: A multicenter cohort study including patients admitted for heart failure to internal medicine departments over a 6-month period will be carried out. Inclusion criteria are patients with a diagnosis of heart failure and at least two criteria of multipathological patients and NT-proBNP >1500 pg/ml upon admission. The PROFUND scale will be applied to all patients. Patients will be then stratified into four groups according to the PROFUND scale: low, moderate, moderate-high and high mortality risk. Conclusion: Our work is a prospective study that aims to apply the PROFUND scale to patients with heart failure in the hospital setting with the purpose of helping in decision-making with our patients, which could lead to improvements in the management of resources in our health system.

[1]  S. Solomon,et al.  Lixisenatide in Patients with Type 2 Diabetes and Acute Coronary Syndrome. , 2015, The New England journal of medicine.

[2]  R. Chang,et al.  Survival in systemic sclerosis-pulmonary arterial hypertension by serum autoantibody status in the Pulmonary Hypertension Assessment and Recognition of Outcomes in Scleroderma (PHAROS) Registry. , 2015, Seminars in arthritis and rheumatism.

[3]  S. Proudman,et al.  Cost savings with a new screening algorithm for pulmonary arterial hypertension in systemic sclerosis , 2015, Internal medicine journal.

[4]  B. Griffiths,et al.  Consensus best practice pathway of the UK Scleroderma Study Group: digital vasculopathy in systemic sclerosis. , 2015, Rheumatology.

[5]  M. Stumvoll,et al.  Cardiovascular and heart failure safety profile of vildagliptin: a meta‐analysis of 17 000 patients , 2015, Diabetes, obesity & metabolism.

[6]  A. Conde-Martel,et al.  Prevalencia y significado pronóstico de la comorbilidad en la insuficiencia cardiaca , 2015 .

[7]  J. Callejas-Rubio,et al.  Registry of the Spanish Network for Systemic Sclerosis , 2015, Medicine.

[8]  Flora Kisuule,et al.  Hospitalists and Their Impact on Quality, Patient Safety, and Satisfaction. , 2015, Obstetrics and gynecology clinics of North America.

[9]  M. Mayes,et al.  Clinical correlates of monospecific anti-PM75 and anti-PM100 antibodies in a tri-nation cohort of 1574 systemic sclerosis subjects , 2015, Autoimmunity.

[10]  J. Ena,et al.  Hyperglycemia management in patients admitted to internal medicine in Spain: A point-prevalence survey examining adequacy of glycemic control and guideline adherence. , 2015, European journal of internal medicine.

[11]  U. Müller-Ladner,et al.  Prediction of worsening of skin fibrosis in patients with diffuse cutaneous systemic sclerosis using the EUSTAR database. , 2015, Annals of the rheumatic diseases.

[12]  J. Cleland,et al.  The Obesity Paradox in Type 2 Diabetes Mellitus: Relationship of Body Mass Index to Prognosis , 2015, Annals of Internal Medicine.

[13]  M. Humbert,et al.  Validation of two predictive models for survival in pulmonary arterial hypertension , 2015, European Respiratory Journal.

[14]  B. Thombs,et al.  Major Depression Diagnoses Among Patients With Systemic Sclerosis: Baseline and One‐Month Followup , 2015, Arthritis care & research.

[15]  U. Müller-Ladner,et al.  Value of systolic pulmonary arterial pressure as a prognostic factor of death in the systemic sclerosis EUSTAR population , 2015, Rheumatology.

[16]  F. Formiga,et al.  Comorbidity in heart failure. Results of the Spanish RICA Registry. , 2014, QJM : monthly journal of the Association of Physicians.

[17]  M. Hudson,et al.  Systemic Sclerosis Sine Scleroderma: A Multicenter Study of 1417 Subjects , 2014, The Journal of Rheumatology.

[18]  R. Simms,et al.  Pulmonary hypertension and interstitial lung disease within PHAROS: impact of extent of fibrosis and pulmonary physiology on cardiac haemodynamic parameters. , 2014, Clinical and experimental rheumatology.

[19]  M. Hudson,et al.  Prevalence and clinical profiles of 'autoantibody-negative' systemic sclerosis subjects. , 2014, Clinical and experimental rheumatology.

[20]  K. Simpson,et al.  New hospital telemedicine services: potential market for a nighttime telehospitalist service. , 2014, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[21]  M. Mayes,et al.  Development of pulmonary hypertension in a high-risk population with systemic sclerosis in the Pulmonary Hypertension Assessment and Recognition of Outcomes in Scleroderma (PHAROS) cohort study. , 2014, Seminars in arthritis and rheumatism.

[22]  M. Hudson,et al.  Autoantibodies to the Rpp25 Component of the Th/To Complex are the Most Common Antibodies in Patients with Systemic Sclerosis without Antibodies Detectable by Widely Available Commercial Tests , 2014, The Journal of Rheumatology.

[23]  M. Hudson,et al.  Clinical and Serologic Correlates of Anti‐PM/Scl Antibodies in Systemic Sclerosis: A Multicenter Study of 763 Patients , 2014, Arthritis & rheumatology.

[24]  M. Hudson,et al.  Myopathy is a poor prognostic feature in systemic sclerosis: results from the Canadian Scleroderma Research Group (CSRG) cohort , 2014, Scandinavian journal of rheumatology.

[25]  M. Baron,et al.  Frailty Index to Measure Health Status in People with Systemic Sclerosis , 2014, The Journal of Rheumatology.

[26]  R. Gómez-Huelgas,et al.  Frequency of hypoglycemia and its impact on length of stay, mortality, and short-term readmission in patients with diabetes hospitalized in internal medicine wards. , 2014, Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists.

[27]  F. Formiga,et al.  Basal functional status predicts three-month mortality after a heart failure hospitalization in elderly patients - the prospective RICA study. , 2014, International journal of cardiology.

[28]  D. Huscher,et al.  Effects and safety of rituximab in systemic sclerosis: an analysis from the European Scleroderma Trial and Research (EUSTAR) group , 2014, Annals of the rheumatic diseases.

[29]  M. Worm,et al.  Disease progression in systemic sclerosis-overlap syndrome is significantly different from limited and diffuse cutaneous systemic sclerosis , 2014, Annals of the rheumatic diseases.

[30]  D. Khanna,et al.  Prevalence, Correlates and Outcomes of Gastric Antral Vascular Ectasia in Systemic Sclerosis: A EUSTAR Case-control Study , 2014, The Journal of Rheumatology.

[31]  P. Boracchi,et al.  Nailfold capillaroscopy in systemic sclerosis: data from the EULAR scleroderma trials and research (EUSTAR) database. , 2013, Microvascular research.

[32]  B. Thombs,et al.  Sleep disturbances in systemic sclerosis: evidence for the role of gastrointestinal symptoms, pain and pruritus. , 2013, Rheumatology.

[33]  U. Müller-Ladner,et al.  Preliminary analysis of the Very Early Diagnosis of Systemic Sclerosis (VEDOSS) EUSTAR multicentre study: evidence for puffy fingers as a pivotal sign for suspicion of systemic sclerosis , 2013, Annals of the rheumatic diseases.

[34]  M. Hudson,et al.  Systemic Sclerosis in Canada’s North American Native Population: Assessment of Clinical and Serological Manifestations , 2013, The Journal of Rheumatology.

[35]  M. Hudson,et al.  Association of Gastroesophageal Factors and Worsening of Forced Vital Capacity in Systemic Sclerosis , 2013, The Journal of Rheumatology.

[36]  Karl Swedberg,et al.  Predicting survival in heart failure: a risk score based on 39 372 patients from 30 studies. , 2013, European heart journal.

[37]  A. Tyndall,et al.  Systemic sclerosis without antinuclear antibodies or Raynaud's phenomenon: a multicentre study in the prospective EULAR Scleroderma Trials and Research (EUSTAR) database. , 2013, Rheumatology.

[38]  R. Caporali,et al.  Clinical significance of coexisting antitopoisomerase I and anticentromere antibodies in patients with systemic sclerosis: a EUSTAR group-based study. , 2013, Clinical and experimental rheumatology.

[39]  M. Hudson,et al.  Low Socioeconomic Status (Measured by Education) and Outcomes in Systemic Sclerosis: Data from the Canadian Scleroderma Research Group , 2013, The Journal of Rheumatology.

[40]  U. Müller-Ladner,et al.  Outcomes of patients with systemic sclerosis-associated polyarthritis and myopathy treated with tocilizumab or abatacept: a EUSTAR observational study , 2012, Annals of the rheumatic diseases.

[41]  U. Müller-Ladner,et al.  Juvenile and young adult-onset systemic sclerosis share the same organ involvement in adulthood: data from the EUSTAR database. , 2012, Rheumatology.

[42]  R. Steele,et al.  Longitudinal Study of Renal Function in Systemic Sclerosis , 2012, The Journal of Rheumatology.

[43]  M. Humbert,et al.  TGFβ receptor gene variants in systemic sclerosis-related pulmonary arterial hypertension: results from a multicentre EUSTAR study of European Caucasian patients , 2012, Annals of the rheumatic diseases.

[44]  J. Callejas-Rubio,et al.  Registry of the Spanish network for systemic sclerosis: clinical pattern according to cutaneous subsets and immunological status. , 2012, Seminars in arthritis and rheumatism.

[45]  R. Steele,et al.  Clinical decision rule to predict the presence of interstitial lung disease in systemic sclerosis , 2012, Arthritis care & research.

[46]  Sameer Ather,et al.  Impact of noncardiac comorbidities on morbidity and mortality in a predominantly male population with heart failure and preserved versus reduced ejection fraction. , 2012, Journal of the American College of Cardiology.

[47]  R. Steele,et al.  Clinical significance of antibodies to Ro52/TRIM21 in systemic sclerosis , 2012, Arthritis Research & Therapy.

[48]  B. Levis,et al.  Rates and correlates of sexual activity and impairment among women with systemic sclerosis , 2012, Arthritis care & research.

[49]  M. Mayes,et al.  Baseline characteristics and follow-up in patients with normal haemodynamics versus borderline mean pulmonary arterial pressure in systemic sclerosis: results from the PHAROS registry , 2012, Annals of the rheumatic diseases.

[50]  P. Nash,et al.  Prevalence, correlates and clinical usefulness of antibodies to RNA polymerase III in systemic sclerosis: a cross-sectional analysis of data from an Australian cohort , 2011, Arthritis research & therapy.

[51]  B. Thombs,et al.  Measuring Pain in Systemic Sclerosis: Comparison of the Short-form McGill Pain Questionnaire Versus a Single-item Measure of Pain , 2011, The Journal of Rheumatology.

[52]  M. Meurer,et al.  Frequency of disease-associated and other nuclear autoantibodies in patients of the German network for systemic scleroderma: correlation with characteristic clinical features , 2011, Arthritis research & therapy.

[53]  R. Gomis,et al.  Prevalence of diabetes mellitus and impaired glucose regulation in Spain: the Di@bet.es Study , 2011, Diabetologia.

[54]  M. Hudson,et al.  Anti-centromere antibodies in a large cohort of systemic sclerosis patients: comparison between immunofluorescence, CENP-A and CENP-B ELISA. , 2011, Clinica chimica acta; international journal of clinical chemistry.

[55]  V. Steen,et al.  Pulmonary Hypertension Assessment and Recognition of Outcomes in Scleroderma (PHAROS): Baseline Characteristics and Description of Study Population , 2011, The Journal of Rheumatology.

[56]  R. Steele,et al.  Validation of the UCLA Scleroderma Clinical Trial Gastrointestinal Tract Instrument Version 2.0 for Systemic Sclerosis , 2011, The Journal of Rheumatology.

[57]  L. Mouthon,et al.  Outcomes of Barrett's oesophagus related to systemic sclerosis: a 3-year EULAR Scleroderma Trials and Research prospective follow-up study. , 2011, Rheumatology.

[58]  A. Gabrielli,et al.  Clinical prediction of 5-year survival in systemic sclerosis: validation of a simple prognostic model in EUSTAR centres , 2011, Annals of the rheumatic diseases.

[59]  M. Mayes,et al.  Anti-Fibrillarin Antibody in African American Patients with Systemic Sclerosis: Immunogenetics, Clinical Features, and Survival Analysis , 2011, The Journal of Rheumatology.

[60]  M. Bernabeu-Wittel,et al.  Development of a new predictive model for polypathological patients. The PROFUND index. , 2011, European journal of internal medicine.

[61]  Oliver Distler,et al.  EUSTAR biobanking: recommendations for the collection, storage and distribution of biospecimens in scleroderma research , 2011, Annals of the rheumatic diseases.

[62]  M. Baron,et al.  Associations with digital ulcers in a large cohort of systemic sclerosis: Results from the Canadian Scleroderma Research Group registry , 2011, Arthritis care & research.

[63]  M. L. Lopes,et al.  Preliminary criteria for the very early diagnosis of systemic sclerosis: results of a Delphi Consensus Study from EULAR Scleroderma Trials and Research Group , 2010, Annals of the rheumatic diseases.

[64]  A. Forbes,et al.  Assessment of gastrointestinal symptoms in patients with systemic sclerosis in a UK tertiary referral centre. , 2010, Rheumatology.

[65]  M. Matucci-Cerinic,et al.  Characteristics of Joint Involvement and Relationships with Systemic Inflammation in Systemic Sclerosis: Results from the EULAR Scleroderma Trial and Research Group (EUSTAR) Database , 2010, The Journal of Rheumatology.

[66]  M. Humbert,et al.  Survival in incident and prevalent cohorts of patients with pulmonary arterial hypertension , 2010, European Respiratory Journal.

[67]  E. Feierl,et al.  Causes and risk factors for death in systemic sclerosis: a study from the EULAR Scleroderma Trials and Research (EUSTAR) database , 2010, Annals of the rheumatic diseases.

[68]  M. Hudson,et al.  Systemic Sclerosis: Establishing Diagnostic Criteria , 2010, Medicine.

[69]  A. Silman,et al.  Observational Study of Treatment Outcome in Early Diffuse Cutaneous Systemic Sclerosis , 2010, The Journal of Rheumatology.

[70]  R. Steele,et al.  Malnutrition Is Common in Systemic Sclerosis: Results from the Canadian Scleroderma Research Group Database , 2009, The Journal of Rheumatology.

[71]  R. Steele,et al.  Work Disability in Systemic Sclerosis , 2009, The Journal of Rheumatology.

[72]  T. Therneau,et al.  Hospitalizations after heart failure diagnosis a community perspective. , 2009, Journal of the American College of Cardiology.

[73]  C. Denton,et al.  A longitudinal study of anti-RNA polymerase III antibody levels in systemic sclerosis. , 2009, Rheumatology.

[74]  M. Humbert,et al.  The three-year incidence of pulmonary arterial hypertension associated with systemic sclerosis in a multicenter nationwide longitudinal study in France. , 2009, Arthritis and rheumatism.

[75]  R. Steele,et al.  Clinical Correlates of Self-reported Physical Health Status in Systemic Sclerosis , 2009, The Journal of Rheumatology.

[76]  J. Gerss,et al.  Comparison of patients with and without digital ulcers in systemic sclerosis: detection of possible risk factors , 2009, The British journal of dermatology.

[77]  W. Lehmacher,et al.  High frequency of corticosteroid and immunosuppressive therapy in patients with systemic sclerosis despite limited evidence for efficacy , 2009, Arthritis research & therapy.

[78]  Grant D. Huang,et al.  Glucose control and vascular complications in veterans with type 2 diabetes. , 2009, The New England journal of medicine.

[79]  M. Hudson,et al.  The cost of systemic sclerosis. , 2008, Arthritis and rheumatism.

[80]  W. Lehmacher,et al.  Skin sclerosis is only of limited value to identify SSc patients with severe manifestations--an analysis of a distinct patient subgroup of the German Systemic Sclerosis Network (DNSS) Register. , 2008, Rheumatology.

[81]  M. Hudson,et al.  Reports of abnormal cervical cancer screening tests in systemic sclerosis. , 2008, Rheumatology.

[82]  M. Matucci-Cerinic,et al.  The EULAR Scleroderma Trials And Research group (EUSTAR): an international framework for accelerating scleroderma research , 2008, Current opinion in rheumatology.

[83]  R. Landewé,et al.  European League Against Rheumatism (EULAR) Scleroderma Trial and Research group (EUSTAR) recommendations for the treatment of systemic sclerosis: methods of elaboration and results of systematic literature research , 2008, Annals of the rheumatic diseases.

[84]  M. Humbert,et al.  Risk factors for death and the 3-year survival of patients with systemic sclerosis: the French ItinérAIR-Sclérodermie study , 2008, Rheumatology.

[85]  U. Müller-Ladner,et al.  Geographical variation of disease manifestations in systemic sclerosis: a report from the EULAR Scleroderma Trials and Research (EUSTAR) group database , 2008, Annals of the rheumatic diseases.

[86]  W. Lehmacher,et al.  The registry of the German Network for Systemic Scleroderma: frequency of disease subsets and patterns of organ involvement , 2008, Rheumatology.

[87]  G. Riemekasten,et al.  Management of cutaneous vascular complications in systemic scleroderma: experience from the German network , 2008, Rheumatology International.

[88]  R. Steele,et al.  Clinical correlates of quality of life in systemic sclerosis measured with the World Health Organization Disability Assessment Schedule II. , 2008, Arthritis and rheumatism.

[89]  M. Aringer,et al.  Prevalence and clinical associations of anti-Ku antibodies in patients with systemic sclerosis: a European EUSTAR-initiated multi-centre case–control study , 2007, Annals of the rheumatic diseases.

[90]  C. Denton,et al.  Mycophenolate mofetil in diffuse cutaneous systemic sclerosis--a retrospective analysis. , 2007, Rheumatology.

[91]  D. Furst,et al.  The EUSTAR model for teaching and implementing the modified Rodnan skin score in systemic sclerosis , 2007, Annals of the rheumatic diseases.

[92]  U. Müller-Ladner,et al.  Clinical risk assessment of organ manifestations in systemic sclerosis: a report from the EULAR Scleroderma Trials And Research group database , 2007, Annals of the rheumatic diseases.

[93]  P. Emery,et al.  A multicenter, prospective, randomized, double-blind, placebo-controlled trial of corticosteroids and intravenous cyclophosphamide followed by oral azathioprine for the treatment of pulmonary fibrosis in scleroderma. , 2006, Arthritis and rheumatism.

[94]  M. Humbert,et al.  Bosentan treatment for pulmonary arterial hypertension related to connective tissue disease: a subgroup analysis of the pivotal clinical trials and their open-label extensions , 2006, Annals of the rheumatic diseases.

[95]  M. Humbert,et al.  Pulmonary arterial hypertension in France: results from a national registry. , 2006, American journal of respiratory and critical care medicine.

[96]  C. Lang,et al.  Non-cardiac comorbidities in chronic heart failure , 2006, Heart.

[97]  M. Humbert,et al.  Early detection of pulmonary arterial hypertension in systemic sclerosis: a French nationwide prospective multicenter study. , 2005, Arthritis and rheumatism.

[98]  Erland Erdmann,et al.  Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study (PROspective pioglitAzone Clinical Trial In macroVascular Events): a randomised controlled trial , 2005, The Lancet.

[99]  M. Matucci-Cerinic,et al.  Systemic sclerosis in Europe: first report from the EULAR Scleroderma Trials And Research (EUSTAR) group database , 2005, Annals of the rheumatic diseases.

[100]  N. Ramírez-Duque,et al.  Incidencia y características clínicas de los pacientes con pluripatología ingresados en una unidad de medicina interna , 2005 .

[101]  Brenda W Gillespie,et al.  Prevalence, incidence, survival, and disease characteristics of systemic sclerosis in a large US population. , 2003, Arthritis and rheumatism.

[102]  W. Lim,et al.  Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study , 2003, Thorax.

[103]  E. Segovia,et al.  Prevalence of heart failure in Asturias (a region in the north of Spain). , 2001, The American journal of cardiology.

[104]  R. Holman,et al.  Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34) , 1998, The Lancet.

[105]  K. Flaherty,et al.  African-American race and antibodies to topoisomerase I are associated with increased severity of scleroderma lung disease. , 1998, Chest.

[106]  Stuart Hall,et al.  Questions of Cultural Identity , 1996 .

[107]  M. Ahern,et al.  A study of scleroderma in South Australia: prevalence, subset characteristics and nailfold capillaroscopy. , 1995, Australian and New Zealand journal of medicine.

[108]  C. Black.  Scleroderma—clinical aspects , 1993, Journal of internal medicine.

[109]  T. Medsger,et al.  Clinical correlations and prognosis based on serum autoantibodies in patients with systemic sclerosis. , 1988, Arthritis and rheumatism.

[110]  Stuart Hall,et al.  Resistance Through Rituals , 1978 .

[111]  R. Davidson-Lamb,et al.  Scleroderma , 1977, Anaesthesia.

[112]  A. Feinstein,et al.  The importance of classifying initial co-morbidity in evaluating the outcome of diabetes mellitus. , 1974, Journal of chronic diseases.

[113]  A. Blenkinsop.  World Health , 1957, Royal Society of Health journal.

[114]  R. Phelps.  Documents on German Foreign Policy, 1918-1945 , 1957 .

[115]  Дашичев Вячеслав Иванович.  Европа в завоевательных планах германского фашизма , 2014 .

[116]  Thomas Hügle,et al.  Late-onset systemic sclerosis--a systematic survey of the EULAR scleroderma trials and research group database. , 2011, Rheumatology.

[117]  M. Baron,et al.  Registries in systemic sclerosis: a worldwide experience. , 2011, Rheumatology.

[118]  Анна Ивановна Вакуленко,et al.  Право Європейського Союзу: навчальний посібник , 2010 .

[119]  S. Schinner.  Effects of Intensive Glucose Lowering in Type 2 Diabetes , 2009 .

[120]  J. R. Banegas,et al.  Situación epidemiológica de la insuficiencia cardiaca en España , 2006 .

[121]  Длигач Андрей Александрович,et al.  Разделяй и властвуй , 2005 .

[122]  В. А. Буханов.  Гитлеровский «новый порядок» в Европе и его крах. 1939—1945 (идейно-политические проблемы) , 1994 .

[123]  Adolf Hitler,et al.  Hitlers Tischgespräche im Führerhauptquartier , 1989 .

[124]  C. Mackenzie,et al.  A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. , 1987, Journal of chronic diseases.

[125]  Abiola Irele.  The African experience in literature and ideology , 1981 .

[126]  M. Girolami.  [Prevention of infectious diseases]. , 1970, Archivio italiano di scienze mediche tropicali e di parassitologia.

[127]  W. Mozart,et al.  Symphony no. 40 in G minor , 1949 .

[128]  Otto Strasser.  Hitler And I , 1940 .