Jacob et al reported the EAHFE-3D scale to predict short-term mortality for a patient with an acute exacerbation of chronic heart failure. This can help to identify a patient who may require more aggressive management. The authors are from multiple institutions in Spain.
EAHFE is Epidemiology of Acute Heart Failure in Emergency Departments which is a data registry.
Parameters:
(1) age in years
(2) baseline NYHA functional class
(3) systolic blood pressure in mm Hg
(4) transcutaneous oxygen saturation in percent
(5) serum sodium in mmol/L
(6) use of vasopressors or inotropic drugs
(7) use of noninvasive ventilation (NIV)
Parameter
Finding
Points
age in years
< 75 years
0
>= 75 years
30
NYHA class
I or II
0
III or IV
15
systolic blood pressure
>= 110 mm Hg
0
< 110 mm Hg
20
oxygen saturation
>= 90%
0
< 90%
30
serum sodium
>= 135 mmol/L
0
< 135 mmol/L
20
inotropic drugs or vasopressors
no
0
yes
30
noninvasive ventilation
no
0
yes
20
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 165
Total Score
Risk Category
3 Day Mortality
0 to 20
very low
0.5%
21 to 40
low
1%
41 to 60
intermediate
3%
61 to 80
high
5-6%
81 to 165
very high
13-22%
Performance:
• The area under the ROC curve was 0.8 for the derivation and 0.76 for the validation cohorts.
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