{
  "abstract": "Background\n\nCardiovascular-kidney-metabolic (CKM) dysfunction integrates cardiac, renal, metabolic, and inflammatory risk and is particularly relevant for older patients hospitalized with heart failure. Whether standardized multidomain CKM-related biomarker assessment is feasible using real-world hospital data in older heart-failure inpatients and what limitations arise from such data remains poorly characterized.Methods\n\nRetrospective cohort study using hospital records from Zhongnan Hospital (Jan 2022-Dec 2024). Patients with missing in-hospital outcome status were excluded. Primary outcome was in-hospital mortality. Associations between age, sex, ECG major abnormality, BNP, BUN, IL-6, and mortality were evaluated using Firth penalized logistic regression in complete-case patients. Nested ROC models described apparent discrimination (DeLong tests), bootstrap resampling estimated optimism-corrected discrimination, and an exploratory CKM biomarker burden analysis was performed.Results\n\nAmong 1,645 records, 1,131 patients had interpretable in-hospital outcomes (64 deaths, 1,067 survivors). A complete CKM biomarker panel (BNP, BUN, and IL-6) was available in only 186 patients (16.4%; 17 deaths, 169 survivors; median non-survivor age 82 years), who were older and had higher observed mortality than patients excluded for incomplete data. In this selected complete-case cohort, only older age (adjusted OR per year, 1.10; 95% CI, 1.04-1.16; P < 0.001) and BNP per doubling (OR, 1.40; 95% CI, 1.05-1.86; P = 0.021) were independently associated with mortality; sex, ECG major abnormality, BUN, and IL-6 were not. Apparent discrimination was numerically higher for the biomarker-enriched than the clinical-ECG model (AUC 0.841 vs. 0.762), but nested DeLong comparisons were not significant (P ≥ 0.060) and the optimism-corrected C-index was 0.79. Observed mortality rose across exploratory CKM-burden groups (8.3%, 12.0%, 20.0%), but these subgroups were very small. The incremental biomarker, ECG, discrimination, and CKM-burden findings remained exploratory and hypothesis-generating.Conclusions\n\nIn this selected complete-case cohort of older heart-failure inpatients, age and BNP were the most consistent markers of in-hospital mortality. A complete CKM biomarker panel was available in only a minority of patients, indicating that standardized multidomain CKM-related assessment was not systematically implemented in routine care. The feasibility, incremental prognostic value, and clinical utility of broader CKM-related multidomain biomarker assessment remain unproven and require standardized prospective validation; these findings should not be interpreted as a prognostic model ready for clinical use.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiology, Zhongnan Hospital, Institute of Myocardial Injury and Repair, Wuhan University, Wuhan University, Wuhan, 430071, PR China.",
    "Hubei Provincial Clinical Research Center for Cardiovascular Intervention, Wuhan, 430071, PR China.",
    "Department of Cardiology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Shaanxi, 710061, China.",
    "Department of Cardiology, Zhongnan Hospital, Institute of Myocardial Injury and Repair, Wuhan University, Wuhan University, Wuhan, 430071, PR China. wangzhiquan1031@whu.edu.cn.",
    "Hubei Provincial Clinical Research Center for Cardiovascular Intervention, Wuhan, 430071, PR China. wangzhiquan1031@whu.edu.cn."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Musa Bin Bashir",
      "orcid": "0000-0001-9678-0512"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Chen Chen",
      "orcid": "0000-0002-8614-1917"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Ho Yong Il",
      "orcid": "0009-0006-2276-0475"
    },
    {
      "affs": [
        2
      ],
      "name": "Rzgar Mustafa Ahmed"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Navneet Navneet"
    },
    {
      "affs": [
        3,
        4
      ],
      "name": "Zhiquan Wang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bjfy7zwss08ze.bib",
  "cited_by": 0,
  "doi": "10.1186/s12877-026-08047-9",
  "fulltext_url": "https://europepmc.org/articles/PMC13700434",
  "id": "bjfy7zwss08ze",
  "issns": [
    "1471-2318"
  ],
  "landing_url": "https://europepmc.org/article/MED/42928107",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2705|Heart Failure Treatment and Management"
    ]
  ],
  "openalex": "W7171492164",
  "pdf_url": "https://europepmc.org/articles/PMC13700434?pdf=render",
  "pmcid": "PMC13700434",
  "pmid": "42928107",
  "published": "2026-07-28",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/bjfy7zwss08ze.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:20Z",
      "native_id": "MED:42928107",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42928107"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Heart Failure Treatment and Management",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Feasibility of multidomain cardiovascular-kidney-metabolic biomarker assessment for in-hospital mortality in older heart failure inpatients: an exploratory retrospective cohort study.",
  "title_text": "Feasibility of multidomain cardiovascular-kidney-metabolic biomarker assessment for in-hospital mortality in older heart failure inpatients: an exploratory retrospective cohort study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:20Z",
  "url": "https://research.draconitic.com/paper/bjfy7zwss08ze",
  "venue": "BMC geriatrics",
  "versions": []
}