Alvarez-Garcia et al developed two scores for evaluating a patient with heart failure. One score predicted the 1-year readmission rate. The authors are from the Spanish Heart Failure Network (REDINSCOR).
Patient selection: age > 18 years, hospitalized for worsening heart failure, previous hospitalization for heart failure in the past year, echocardiographic abnormalities
Exclusion: acute reversible heart failure, repairable severe valvular disease, chronic cor pulmonale, terminal illness
Outcome: 1-year readmission
Parameters:
(1) Framingham signs of left heart failure (paroxysmal nocturnal dyspnea, rales, orthopnea, third sound gallop)
(2) estimated GFR (eGFR) in mL per min per 1.73 square meter
(3) BNP in pmol/L or NT-proBNP in pmol/L
(4) heart rate in beats per minute
(5) anemia (hemoglobin in g/L and gender)
(6) left atrial size in mm per square meter
|
Parameter |
Finding |
Points |
|
signs of left heart failure |
absent |
0 |
|
|
present |
5 |
|
eGFR |
>= 60 mL per min per 1.73 square meter |
0 |
|
|
< 60 mL per min per 1.73 square meter |
4 |
|
BNP or NT-proBNP |
not elevated |
0 |
|
|
elevated (BNP > 43 pmol/L; NT-proBNP > 118 pmol/L) |
8 |
|
heart rate |
<= 70 beats per minute |
0 |
|
|
> 70 beats per minute |
4 |
|
Anemia |
absent |
0 |
|
|
present (< 130 g/L for males, < 120 g/L for females) |
4 |
|
left atrial size |
<= 26 mm per sq m |
0 |
|
|
> 26 mm per sq m |
5 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 30
• The higher the score the greater the risk of 1-year readmission for heart failure.
|
Total Score |
30-day Readmission |
|
0 to 12 |
7.8% |
|
13 to 20 |
15.6% |
|
21 to 33 |
26% |
Performance:
• The area under the ROC curve is 0.66.
Specialty: Cardiology
