Objective:

To identify the optimal TFQI cutoff for risk stratification and evaluate its association with adverse outcomes in heart failure patients.

Approach:

• Study Design: Retrospective cohort analysis of 402 hospitalized heart failure patients.
• Outcome Measures: Composite outcome of 90-day all-cause mortality or heart failure readmission.
• Statistical Analysis: Determined optimal TFQI threshold using X-tile project; evaluated predictive value with Cox regression, RCS analysis, and Kaplan-Meier curves.

Key Findings:

• A threshold of 0.10 best stratified high-risk patients (adjusted HR: 1.95, 95% CI: 1.11–3.43, P = 0.019).
• RCS analysis indicated a linear dose-response (P for non-linearity = 0.677).
• Kaplan–Meier analysis confirmed significantly worse survival with TFQI > 0.10 vs ≤ 0.10 (Log-rank P = 0.004).

Interpretation:

A TFQI exceeding 0.10 is associated with a significantly increased risk of 90-day all-cause mortality or heart failure readmission in hospitalized heart failure patients.

Limitations:

• Study is retrospective and conducted at a single center.
• Further large-scale, multicenter, and prospective studies are needed to confirm findings.

Conclusion:

Further large-scale, multicenter, and prospective studies are needed to confirm findings.