Patient selection: age > 18 years, hospitalized for worsening heart failure, previous hospitalization for heart failure in the past year, echocardiographic abnormalities
Exclusion: acute reversible heart failure, repairable severe valvular disease, chronic cor pulmonale, terminal illness
Outcome: 30 day readmission
Parameters:
(1) Framingham signs of left heart failure (paroxysmal nocturnal dyspnea, rales, orthopnea, third sound gallop)
(2) estimated GFR (eGFR) in mL per min per 1.73 square meter
(3) BNP in pmol/L or NT-proBNP in pmol/L
|
Parameter
|
Finding
|
Points
|
|
signs of left heart failure
|
absent
|
0
|
|
|
present
|
10
|
|
eGFR
|
>= 60 mL per min per 1.73 square meter
|
0
|
|
|
< 60 mL per min per 1.73 square meter
|
6
|
|
BNP or NT-proBNP
|
not elevated
|
0
|
|
|
elevated (BNP > 43 pmol/L; NT-proBNP > 118 pmol/L)
|
14
|
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 30
• The higher the score the greater the risk of 30-day readmission for heart failure.
|
Total Score
|
30-day Readmission
|
|
< 20
|
0.9%
|
|
>= 20
|
5%
|
Performance:
• The area under the ROC curve is 0.72.
