### Description

Brophy et al developed models for predicting survival at 12 and 36 months for a patient with heart failure. This can help identify a patient who may benefit from more aggressive or a novel therapy. The authors are from McGill University, VA Medical Center at Perry Point, and McMaster University.

Parameters:

(1) left ventricular ejection fraction in percent (limits are from 3 to 45%)

(2) NYHA class

(3) cardiothoracic ratio in percent

(4) clinical signs and symptoms (peripheral edema, rales, elevated jugular venous pressure, dyspnea at rest or on exertion, S gallop, limited activity, pulmonary congestion on X-ray)

(5) serum creatinine in mg/dL over range of 0.3 to 3.0 mg/dL

(6) body mass index (BMI) in kg per square meter

(7) diastolic blood pressure in mm Hg

(8) etiology of the heart failure

points for the ejection fraction =

= 0.2927 * (45 - (percent LVEF)) / 10

points for serum creatinine =

= 0.6152 * (serum creatinine)

Parameter

Finding

Points

NYHA class

I

0

II

0.3646

III or IV

0.7293

cardiothoracic ratio in percent

<= 50%

0

> 50%

0.47

number of clinical signs

0 or 1

0

2 or 3

0.19

4 or 5

0.38

6 or 7

0.572

BMI

<= 23.6

0

23.7 to 26.4

0.1655

26.5 to 29.7

0.331

>= 29.8

0.4965

diastolic blood pressure

<= 69 mm Hg

0

70 to 74 mm Hg

0.157

75 to 80 mm Hg

0.314

>= 81 mm Hg

0.471

etiology

diabetic ischemic

0.3784

other

0

where:

• The points in the table are based on the natural logarithm of the hazard ratio (from Table 2) times the reference group from Table 1.

patient sum  =

= (points for ejection fraction) + (points for serum creatinine) + SUM(points for points in table)+

Y =

= EXP((patient sum) - 3.42)

percent survival at 12 months =

= (0.888 ^ Y)

where:

• 3.42 is the mean value.

• 0.888 is the overall average 12 month survival.