Prediction Rule of van Riet et al for Early Detection of Heart Failure in an Older Adult with Non-Acute Shortness of Breath

Description

van Riet et al reported a prediction rule for the early detection of heart failure in an older adult with non-acute shortness of breath. This was based on the model of Rutten et al. The authors are from the University Medical Center Utrecht in The Netherlands.

Patient selection: community-dwelling and >= 65 years of age, non-acute shortness of breath on exertion

Parameters:

(1) ischemic heart disease

(2) body mass index (BMI) in kg per sq m

(3) laterally displaced apex beat

(4) heart rate in beats per minute

(5) serum NTproBNP in pmol/L

(6) ECG

(7) peripheral edema

(8) age in years

(9) systolic heart murmur

Parameter	Finding	Points
ischemic heart disease	no	0
	yes	2
BMI	<= 30	0
	> 30	4
laterally displaced apex	no	0
	yes	4
heart rate	<= 90 beats per minute	0
	> 90 beats per minute	1
serum NTproBNP	<= 14.75 pmol/L	0
	> 14.75 pmol/L	9
ECG	normal	0
	abnormal	5
peripheral edema	no	0
	yes	4
age	<= 75 years	0
	> 75 years	3
systolic murmur	no	0
	yes	3

total score =

= SUM(points for all 9 parameters)

Interpretation:

• minimum score: 0

• maximum score: 35

• A score < 21 is associated with an absence of heart failure.

• A score >= 21 may be associated with heart failure and the patient is referred to echocardiography.

Performance:

• The area under the ROC curve is 0.88.

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Prediction Rule of van Riet et al for Early Detection of Heart Failure in an Older Adult with Non-Acute Shortness of Breath

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