Description

Rassi et al developed a risk score for predicting mortality in patients with Chagas' heart disease. This can help identify patients who may benefit from more aggressive therapy or the use of a new technology. The authors are from Anis Rassi Hospital (Brazil), Wake Forest University, University of Sao Paulo and the Evandro Chagas Clinical Research Institute.


Parameters:

(1) New York Heart Association (NYHA) functional class

(2) cardiomegaly on chest X-ray

(3) left ventricular systolic dysfunction on echocardiography

(4) nonsustainted ventricular tachycardia on 24 hour Holter monitoring

(5) QRS voltage on ECG

(6) gender

 

Parameter

Finding

Points

NYHA class

I or II

0

 

III or IV

5

cardiomegaly on chest X-ray

absent

0

 

present

5

LV systolic dysfunction

absent

0

 

present

3

nonsustained ventricular tachycardia

absent

0

 

present

3

QRS voltage

normal or high

0

 

low

2

gender

female

0

 

male

2

 

total score =

= SUM(points for all 6 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 20

• The higher the score the greater the risk for mortality.

 

Total Score

Mortality Risk

10 Year Mortality Rate

0 to 6

low

10%

7 to 11

intermediate

44%

12 to 20

high

84%

 


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