Senni et al reported the 3C-HF score for patients with heart failure. This score correlates with outcomes and is based on comorbid and cardiac conditions. The authors are from multiple hospitals in Italy.
Patient selection: heart failure
Outcome: death or urgent heart transplant
Parameters:
(1) age in years
(2) NYHA class
(3) left ventricular ejection fraction in percent (LVEF)
(4) RAS inhibitor therapy (renin-angiotensin system)
(5) heart valve disease
(6) atrial fibrillation
(7) beta blocker therapy
(8) chronic kidney dysfunction
(9) diabetes with target organ damage (retinopathy, neuropathy, nephropathy, coronary artery disease, peripheral artery disease)
(10) anemia
(11) hypertension
points for age =
= MAX(0,INT(((age)-40)/10))
|
Parameter |
Finding |
Points |
|
NYHA class |
I or II |
0 |
|
|
III or IV |
13 |
|
LVEF |
>= 20% |
0 |
|
|
< 20% |
11 |
|
RAS inhibitor |
yes |
0 |
|
|
no |
8 |
|
heart valve disease |
none, mild, moderate |
0 |
|
|
severe |
7 |
|
atrial fibrillation |
no |
0 |
|
|
yes |
7 |
|
beta blocker therapy |
yes |
0 |
|
|
no |
4 |
|
chronic kidney dysfunction |
no |
0 |
|
|
yes |
6 |
|
diabetes with target organ damage |
no |
0 |
|
|
yes |
6 |
|
anemia |
no |
0 |
|
|
yes |
4 |
|
hypertension |
no |
0 |
|
|
yes |
-4 |
where:
• There are several ways that age can be handled. One is making it discrete by decade (INT). A second is to go to the nearest decade (ROUND). A third is to make it continuous (no function).
total score =
= SUM(points for all 11 parameters)
Interpretation:
• minimum score: -4
• maximum score: 72 (higher if > 100 years old)
• The higher the score the worse the outcome.
|
Total Score |
Poor Outcome in 1 Year |
|
< 5 |
1.7% |
|
5 to 8 |
3.4% |
|
9 to 11 |
6.7% |
|
12 to 15 |
8.8% |
|
16 to 19 |
11.7% |
|
20 to 24 |
20% |
|
25 to 31 |
29% |
|
>= 32 |
47% |
Specialty: Cardiology
