Risk Score of Jones et al for Mortality in a Patient with Heart Failure and Preserved Systolic Function

Patient selection - both of the following:

(1) clinical heart failure

(2) preserved left ventricular ejection fraction (> 45%)

Parameters:

(1) glomerular filtration rate (GFR) in mL per min per square meter BSA

(2) NYHA functional class

(3) gender

(4) age in years

(5) use of diuretics

(6) use of potassium-sparing diuretics

(7) body mass index (BMI) in kg per square meter

(8) cardiothoracic (CT) ratio on AP chest X-ray (mean approximately 0.5)

(9) diabetes mellitus

(10) use of vasodilators

X =

= (0.94250 * (60 / (GFR))) + (0.49544 * (points for NYHA class)) - (0.53467 * (points for gender)) + (0.77739 * (((age in years) / 65)^2)) + (0.60422 * (points for diuretics)) + (0.88877 * (30 / (BMI))) + (2.13163 * ((CT ratio)^2)) + (0.37152 * (points for diabetes)) + (0.34986 * (points for vasodilators)) + (0.55798 * (points for potassium-sparing diuretics))

risk score =

= 10 * X

Interpretation:

• The risk score is stratified based on population quartiles (unfortunately the cutoff points were not listed in the paper).

from Figure 2, page 1028

Most important predictors for mortality:

(1) worsening renal function  (in Figure 1 the highest quartile was < 47 mL per min per square meter)

(2) NYHA functional class III or IV

(3) male gender

(4) older age (in Figure 1 the highest quartile was > 74 years)