Okazaki et al reported the APACHE-HF score for evaluating a patient with heart failure. This can help to identify a patient who may benefit from more aggressive management. The authors are from Nippon Medical School and Chiba Hokusoh Hospital in Japan.
Patient selection: acute heart failure
Parameters:
(1) mean arterial pressure in mm Hg
(2) pulse in beats per minute
(3) serum sodium in mmol/L
(4) serum potassium in mmol/L
(5) serum creatinine in mg/dL
(6) hematocrit in percent
(7) Glasgow Coma score
(8) age in years
Parameter
Finding
Points
mean arterial pressure
>= 91.5
0
< 91.5
1
pulse
> 110
0
<= 110
1
serum sodium
>= 138
0
< 138
1
serum potassium
<= 4.8
0
> 4.8
1
serum creatinine
<=1.47
0
> 1.47
1
hematocrit
>= 37%
0
< 37%
1
Glasgow coma score
14 or 15
0
3 to 13
1
age in years
< 71.5
0
>= 71.5
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• The prognosis is worse for a patient with a score >= 3.
Score
Group
0
1
1 or 2
2
3 or 4
3
5 or 6
4
7 or 8
5
Performance:
• The area under the ROC curve is 0.78.
• The sensitivity is 88% and specificity 64%.
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