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 9 to 18 years of age
Parameters:
(1) nausea and vomiting
(2) maximal oxygen uptake as percent of predicted for age and sex
(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 |
|
nausea and vomiting |
none |
0 |
|
|
intermittent |
1 |
|
|
frequent |
2 |
|
percent maxVO2 |
> 80% |
0 |
|
|
60 to 80% |
1 |
|
|
< 60% |
2 |
|
breathing |
normal |
0 |
|
|
tachypnea |
1 |
|
|
retractions |
2 |
|
respiratory rate |
<20 breaths per minute |
0 |
|
|
20 to 30 breaths per minute |
1 |
|
|
>30 breaths per minute |
2 |
|
heart rate |
<90 beats per minute |
0 |
|
|
90 to 100 beats per minute |
1 |
|
|
> 100 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 |
<300pg/mL |
0 |
|
|
300 to 1,500 pg/mL |
1 |
|
|
> 1,500 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
