Ross reported a classification for heart failure in pediatric patients based on age strata. The author is from the Children's Hospital of Michigan and Wayne State University.
Patient selection: infant from 1 to 3 of age
Parameters:
(1) feeding
(2) growth
(3) breathing
(4) respiratory rate in breaths per minute
(5) heart rate in beats per minute
(6) perfusion
(7) hepatomegaly in cm
(8) serum NT-proBNP in pg/mL (obtained after 4 days of life)
(9) left ventricular ejection fraction in percent
(10) systemic atrioventricular valve insufficiency
|
Parameter |
Finding |
Points |
|
feeding |
normal |
0 |
|
|
decreased |
1 |
|
|
gavaged |
2 |
|
growth |
normal |
0 |
|
|
weight loss |
1 |
|
|
cachexia |
2 |
|
breathing |
normal |
0 |
|
|
tachypnea |
1 |
|
|
retractions |
2 |
|
respiratory rate |
<30 breaths per minute |
0 |
|
|
30 to 40 breaths per minute |
1 |
|
|
>40 breaths per minute |
2 |
|
heart rate |
< 110 beats per minute |
0 |
|
|
110 to 120 beats per minute |
1 |
|
|
> 120 beats per minute |
2 |
|
perfusion |
normal |
0 |
|
|
reduced |
1 |
|
|
shocky |
2 |
|
hepatomegaly |
< 2 cm |
0 |
|
|
2 to 3 cm |
1 |
|
|
> 3 cm |
2 |
|
serum NT-proBNP |
< 450 pg/mL |
0 |
|
|
450 to 1,700 pg/mL |
1 |
|
|
> 1,700 pg/mL |
2 |
|
LVEF |
> 50% |
0 |
|
|
30 to 50% |
1 |
|
|
< 30% |
2 |
|
systemic AV insufficiency |
none |
0 |
|
|
mild |
1 |
|
|
moderate or severe |
2 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 20
• The higher the score the more severe the heart failure.
|
Score |
Ross Class |
|
0 to 5 |
I |
|
6 to 10 |
II |
|
11 to 15 |
III |
|
16 to 20 |
IV |
Specialty: Cardiology
