Pocock et al developed a score that is predictive of mortality in patients with chronic heart failure. This can help to identify a patient who may benefit from more aggressive management. The authors are from the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC).
Patient selection: chronic heart failure
Outcome: 3-year mortality
Parameters:
(1) left ventricular ejection fraction in percent
(2) composite of age and ejection fraction
(3) composite of systolic blood pressure and ejection fraction
(4) body mass index (BMI) in kg per square meter
(5) serum creatinine in µmol/L
(6) NYHA Class (from 1 to 4)
(7) gender
(8) current smoking status
(9) diabetes
(10) COPD
(11) first diagnosis of heart failure in the past 18 months
(12) beta blocker therapy
(13) ACEI/ARB therapy (angiotensin converting enzyme inhibitor, angiotensin II receptor blocker)
|
Parameter |
Finding |
Points |
|
ejection fraction in percent |
>= 40% |
0 |
|
|
35 to 39% |
2 |
|
|
30 to 34% |
3 |
|
|
25 to 29% |
5 |
|
|
20 to 24% |
6 |
|
|
< 20% |
7 |
|
BMI |
< 15 |
6 |
|
|
15 to 19 |
5 |
|
|
20 to 24 |
3 |
|
|
25 to 29 |
2 |
|
|
>= 30 |
0 |
|
serum creatinine |
< 90 µmol/L |
0 |
|
|
90 to 109 |
1 |
|
|
110 to 129 |
2 |
|
|
130 to 149 |
3 |
|
|
150 to 169 |
4 |
|
|
170 to 209 |
5 |
|
|
210 to 249 |
6 |
|
|
>= 250 |
8 |
|
NYHA |
Class 1 |
0 |
|
|
Class 2 |
2 |
|
|
Class 3 |
6 |
|
|
Class 4 |
8 |
|
gender |
male |
1 |
|
|
female |
0 |
|
current smoker |
no |
0 |
|
|
yes |
1 |
|
diabetes |
no |
0 |
|
|
yes |
3 |
|
COPD |
no |
0 |
|
|
yes |
2 |
|
time with CHF |
<= 18 months |
2 |
|
|
> 18 months |
0 |
|
beta blocker |
no |
3 |
|
|
yes |
0 |
|
ACEI or ARB |
no |
1 |
|
|
yes |
0 |
|
Age |
Ejection Fraction |
Points |
|
< 55 years |
>= 40% |
0 |
|
|
30 to 39% |
0 |
|
|
< 30% |
0 |
|
56 to 59 |
>= 40% |
3 |
|
|
30 to 39% |
2 |
|
|
< 30% |
1 |
|
60 to 64 |
>= 40% |
5 |
|
|
30 to 39% |
4 |
|
|
< 30% |
2 |
|
65 to 69 |
>= 40% |
7 |
|
|
30 to 39% |
6 |
|
|
< 30% |
4 |
|
70 to 74 |
>= 40% |
9 |
|
|
30 to 39% |
8 |
|
|
< 30% |
6 |
|
75 to 79 |
>= 40% |
12 |
|
|
30 to 39% |
10 |
|
|
< 30% |
8 |
|
>= 80 |
>= 40% |
15 |
|
|
30 to 39% |
13 |
|
|
< 30% |
10 |
|
Systolic Blood Pressure |
Ejection Fraction |
Points |
|
< 110 |
>= 40% |
2 |
|
|
30 to 39% |
3 |
|
|
< 30% |
5 |
|
110 to 119 |
>= 40% |
1 |
|
|
30 to 39% |
2 |
|
|
< 30% |
4 |
|
120 to 129 |
>= 40% |
1 |
|
|
30 to 39% |
1 |
|
|
< 30% |
3 |
|
130 to 139 |
>= 40% |
0 |
|
|
30 to 39% |
1 |
|
|
< 30% |
2 |
|
140 to 149 |
>= 40% |
0 |
|
|
30 to 39% |
0 |
|
|
< 30% |
1 |
|
>= 150 |
>= 40% |
0 |
|
|
30 to 39% |
0 |
|
|
< 30% |
0 |
total score =
= SUM(points for all 13 parameters)
Interpretation:
• minimum score: 0
• maximum score: 62
• The higher the score the greater the mortality.
|
Score |
Mortality Rate in Percent |
|
0 to 15 |
(0.028 * ((score)^2)) + (0.476 * (score)) + 3.33 |
|
15 to 30 |
(0.071 * ((score)^2)) - (0.637 * (score)) + 10.35 |
|
30 to 45 |
(-0.112 * ((score)^2)) + (11.22 * (score)) - 180.7 |
|
> 45 |
> 97% |
Specialty: Cardiology
