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 0 to 3 months of age
Parameters:
(1) ounces per feeding
(2) time for feeding in minutes
(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 |
|
ounces per feeding |
> 3.5 oz |
0 |
|
|
2.5 to 3.5 oz |
1 |
|
|
< 2.5 oz |
2 |
|
time for feeding |
< 20 minutes |
0 |
|
|
20 to 40 minutes |
1 |
|
|
> 40 minutes |
2 |
|
breathing |
normal |
0 |
|
|
tachypnea |
1 |
|
|
retractions |
2 |
|
respiratory rate |
< 50 breaths per minute |
0 |
|
|
50 to 60 breaths per minute |
1 |
|
|
> 60 breaths per minute |
2 |
|
heart rate |
< 160 beats per minute |
0 |
|
|
160 to 170 beats per minute |
1 |
|
|
> 170 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 |
References:
Ross RD. The Ross classification for heart failure in children after 25 years: A review and an age-stratified revision. PediatrCardiol. 2012; 33: 1295-1300.
>>>06.11.134 Age-Based Ross Classification for Heart Failure in Pediatric Patients: 4 to 12 Months of Age
Overview:
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 4 to 12 months of age
Parameters:
(1) feeding
(2) weight curve percentile (indicative of a fall-off in 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 |
|
weight curve percentile |
normal (> 50th%) |
0 |
|
|
25 to 50th percentile |
1 |
|
|
10 to 25th percentile (or lower) |
2 |
|
breathing |
normal |
0 |
|
|
tachypnea |
1 |
|
|
retractions |
2 |
|
respiratory rate |
< 40 breaths per minute |
0 |
|
|
40 to 50 breaths per minute |
1 |
|
|
> 50 breaths per minute |
2 |
|
heart rate |
< 120 beats per minute |
0 |
|
|
120 to 130 beats per minute |
1 |
|
|
> 130 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
