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Munich Score for Predicting Survival of a Patient with Chronic Heart Failure

Purpose: To determine the prognosis for a patient with chronic heart failure using the Munich Score of Stempfle et al.

Description

Stempfle et al developed the Munich Score to predict survival for patients with chronic heart failure. This can help to identify a patient who may benefit from more aggressive or a novel therapy. The authors are from Asklepios Stadtklinik Bad Tolz, Poliklinkik Innenstadt Munich, Massachusetts General Hospital and UMIT-University of Health Sciences, Medical Informatics and Technology (Tyrol, Austria).


Outcome: death or heart transplantation

 

Parameters:

(1) ischemic cardiomyopathy

(2) left ventricular end-diastolic diameter in mm

(3) maximal workload in Watts

(4) worsening of fractional shortening in percent (fractional shortening is based on the percentage of systolic fall in left ventricular dimension versus the end-diastolic diameter)

(5) systolic blood pressure in mm Hg

 

Parameter

Finding

Points

ischemic cardiomyopathy

no

0

 

yes

2

LV ED diameter

<= 65 mm

0

 

66 to 75 mm

2

 

>= 76 mm

4

maximum workload

<= 70 W

4

 

71 to 110 W

2

 

>= 111 W

0

percent worsening of fractional shortening

<= +4.0

0

 

> +4.0

1

systolic blood pressure

<= 95 mm Hg

4

 

96 to 115 mm Hg

3

 

>= 116 mm Hg

0

 

Munich score =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 15

• The higher the score the greater the risk for the patient.

 

Munich Score

Risk Group

5 Year Survival

0 to 3

low

100%

4 to 7

intermediate

45%

8 to 15

high

0%


 


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Specialty

Objective

ICD-10