Shiraishi et al reported a clinical prediction model for a patient with acute heart failure. This can help to identify a patient who may require more aggressive management. The authors are from multiple institutions in Japan.
Patient selection: acute heart failure
Parameters:
(1) age in years
(2) systolic pressure in mm Hg
(3) serum BUN in mg/dL
(4) serum sodium in mmol/L
(5) serum albumin in g/dL
(6) serum BNP or serum NT-proBNP in pg/mL
SOB-ASAP is an acronym for sodium, BUN, age, systolic, albumin, and natriuretic peptide.
Parameters
Finding
Points
age in years
< 85 years
0
>= 85 years
2
systolic blood pressure
< 100 mm Hg
3
100 to 140
1
> 140 mm Hg
0
serum BUN
< 40 mg/dL
0
>= 40 mg/dL
2
serum sodium
<= 135 mmol/L
2
> 135 mmol/L
0
serum albumin
<= 3.0 g/dL
3
> 3 g/dL
0
serum BNP
< 1000 pg/mL
0
>= 1000 pg/mL
2
serum pro-NTproBNP
< 4000 pg/mL
0
>= 4000 pg/mL
2
total score =
= SUM(points for the parameters, with either BNP or NT-proBNP)
Interpretation:
• minimum score: 0
• maximum score: 14
Total Score
Mortality Rate
0 or 1
< 1%
2 to 4
1-5%
5 or 6
5-10%
7 or 8
10-30%
9 to 14
> 30%
Performance:
• The area under the ROC curve is 0.82.
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