Miro et al reported the MEESSI score for evaluating a patient with acute heart failure. The authors are from multiple institutions in Spain.
Parameters:
(1) Barthel index on admission
(2) systolic blood pressure in mm Hg
(3) age in years
(4) NT-ProBNP in pg/mL
(5) serum potassium in mmol/L
(6) serum troponin
(7) NYHA functional class on admission
(8) respiratory rate in breaths per minute
(9) low output symptoms (confusion, weakness, cold periphery, poor perfusion, oligura or anuria)
(10) oxygen saturation in percent
(11) episode associated with acute coronary syndrome (ACS)
(12) hypertrophy on ECG
(13) serum creatinine in mg/dL
|
Parameter |
Finding |
Points |
|
Barthel index |
>= 75 |
0 |
|
|
50 to 74 |
0.42 |
|
|
25 to 49 |
0.848 |
|
|
< 25 |
1.383 |
|
systolic blood pressure |
< 95 mm Hg |
1.108 |
|
|
95-109 |
0.923 |
|
|
110-124 |
0.943 |
|
|
125-139 |
0.722 |
|
|
140-154 |
0.421 |
|
|
>= 155 |
0 |
|
age in years |
< 75 years |
0 |
|
|
75 to 79 |
0.462 |
|
|
80 to 84 |
0.554 |
|
|
85 to 89 |
0.544 |
|
|
>=90 |
0.963 |
|
NT-ProBNP |
< 8,000 |
0 |
|
|
8,000 to 15,999 |
0.495 |
|
|
16,000 to 23,999 |
0.714 |
|
|
>= 24,000 |
0.951 |
|
serum potassium |
< 3.5 mmol/L |
0.390 |
|
|
3.5 to 4.9 |
0 |
|
|
5.0 to 5.5 |
0.303 |
|
|
> 5.5 mmol/L |
0.736 |
|
serum troponin |
negative |
0 |
|
|
positive |
0.557 |
|
NHYA functional class |
I, II or III |
0 |
|
|
IV |
0.491 |
|
respiratory rate |
< 25 breaths per minute |
0 |
|
|
25 to 29 |
0.297 |
|
|
>= 30 breaths per minute |
0.523 |
|
low output symptoms |
no |
0 |
|
|
yes |
0.390 |
|
oxygen saturation |
>= 95 |
0 |
|
|
90 to 94 |
0.171 |
|
|
85.01 to 89 |
0.296 |
|
|
<= 85% |
0.512 |
|
associated with ACS |
no |
0 |
|
|
yes |
0.704 |
|
LV hypertrophy on ECG |
no |
0 |
|
|
yes |
0.464 |
|
serum creatinine |
< 1.5 mg/dL |
0 |
|
|
1.5 to 2.4 mg/dL |
0.241 |
|
|
>= 2.5 mg/dL |
0.376 |
sum of the beta coefficients =
= SUM(points for all of the parameters)
value of X -
= (score) -5.40
Interpretation:
• minimum sum of coefficients: 0
• maximum score: coefficients: 9.158
|
Score |
Risk |
30-Day Mortality |
|
first and second quintiles |
low |
2% |
|
third and fourth quintiles |
intermediate |
8% |
|
9th decile |
high |
18-20% |
|
top decile |
very high |
41% |
Performance:
• The area under the ROC curve for 30-day mortality was 0.81.
Specialty: Cardiology
