Chin and Goldman identified a number of risk factors associated with a poor outcome for a patient admitted to the hospital with congestive heart failure. This can help to identify a patient who may benefit from more aggressive management. The authors are from Brigham and Women's Hospital in Boston.
NOTE: Chin and Goldman developed another prognostic score described above (06.11.22)
Outcomes: major complication or death during the hospitalization
Parameters:
(1) systolic blood pressure in mm Hg on admission
(2) respiratory rate in breaths per minute on admission
(3) serum sodium in mmol/L
(4) ST-T wave changes on the initial ECG
Parameter
Finding
Points
systolic blood pressure
> 90 mm Hg
0
<= 90 mm Hg (hypotension)
1
respiratory rate
<= 30 breaths per minute
0
> 30 breaths per minute
1
serum sodium
> 135 mmol/L
0
<= 135 mmol/L
1
ST-T wave changes
absent
0
present but old or due to digoxin effect
0
present if not attributable
1
total risk score =
= SUM(points for all 4 parameters:
Interpretation:
• minimum score: 0
• maximum score: 4
• The higher the score the greater the risk for a poor outcome.
• A poor outcome was seen in 6% of patients with no risk factors.
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