Ross et al developed a score for grading congestive heart failure (CHF) in an infant. Laer et al modified the score and extended its range to early adolescence. The authors are from University of Hamburg-Eppendorf and University of Tennessee.
Patient selection: pediatric patient with heart failure
Parameters:
(1) diaphoresis
(2) tachypnea
(3) breathing
(4) respiratory rate for age in breaths per minute
(5) heart rate for age in beats per minute
(6) hepatomegaly (distance of the liver edge below the right costal margin in cm)
Parameter
Finding
Points
diaphoresis
head only
0
head and body on exertion
1
head and body at rest
2
tachypnea
rare
0
several times
1
frequent
2
breathing
normal
0
retractions
1
dyspnea
2
liver edge
< 2 cm below costal margin
0
2 to 3 cm below costal margin
1
> 3 cm below costal margin
2
Age
Respiratory Rate
Points
0 to 1
< 50
0
50 to 60
1
> 60
2
1 to 6
< 35
0
35 to 45
1
> 45
2
7 to 10
< 25
0
25 to 35
1
> 35
2
11 to 14
< 18
0
18 to 28
1
> 28
2
Age
Heart Rate
Points
0 to 1
<160
0
160 to 170
1
> 170
2
1 to 6
< 105
0
105 to 115
1
> 115
2
7 to 10
< 90
0
90 to 100
1
> 100
2
11 to 14
< 80
0
80 to 90
1
> 90
2
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 12
• The higher the score the more severe the heart failure.
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