Hummel et al developed the Heart Failure Patient Severity Index (HFPSI) to stratify patients with heart failure according to risk. This can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Michigan and the Ann Arbor Veterans Affairs Medical Center.
Patient selection: heart failure
Outcome: 6-month risk of death and/or medical hospitalization
Parameters:
(1) BUN in mg/dL
(2) serum BNP in pg/mL
(3) diabetes mellitus
(4) atrial fibrillation or flutter
(5) NYHA class
(6) prior hospitalization (all cause)
|
Parameter |
Finding |
Points |
|
BUN |
<= 20 mg/dL |
0 |
|
|
21 to 34 |
1 |
|
|
35 to 50 |
2 |
|
|
>= 51 |
3 |
|
BNP |
<= 55 pg/mL |
0 |
|
|
56 to 148 |
2 |
|
|
149 to 403 |
3 |
|
|
> 403 pg/mL |
5 |
|
diabetes mellitus |
absent |
0 |
|
|
present |
1 |
|
atrial fibrillation or flutter |
absent |
0 |
|
|
present |
1 |
|
NYHA class |
1 or 2 |
0 |
|
|
3 |
1 |
|
|
4 |
2 |
|
prior hospitalization |
within past month |
5 |
|
|
from 2-6 months ago |
2 |
|
|
other |
0 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 17
• The higher the score the greater the risk.
|
Total Score |
Group |
Risk |
|
0 to 3 |
1 |
low |
|
4 to 6 |
2 |
low to moderate |
|
7 to 9 |
3 |
moderate |
|
10 to 17 |
4 |
high |
Performance:
• The area under the ROC curve was around 0.70.
Purpose: To risk stratify a patient with heart failure using the Heart Failure Patient Severity Index (HFPSI) of Hummel et al.
Specialty: Cardiology
Objective: severity, prognosis, stage
ICD-10: I50,
