Feola et al developed a score for predicting 1-year mortality in an older adult with congestive heart failure. This can help to identify a patient who may be a candidate for an implantable cardiac defibrillator. The authors are from Ospedale SS Trinita Fossano and Universita degli Studi Torino in Italy.
Patient selection: older adult with a new diagnosis of CHF or an acute episode of decompensation in chronic CHF (age given as 72 years)
Parameters:
(1) serum creatinine in mg/dL
(2) left ventricular ejection fraction in percent
(3) NYHA class at admission
(4) Barthel index on admission (from 0 to 100)
(5) serum BNP on admission in pg/mL (Alere Diagnostics)
Parameter
Finding
Points
serum creatinine
< 1.3 mg/dL
0
1.3 to 1.5 mg/dL
1
> 1.5 mg/dL
2
LVEF
> 45%
0
35-45%
1
< 35%
2
NYHA class
I or II
0
III
1
IV
2
Barthel index
> 80
0
70 to 80
1
< 70
2
BNP on admission
< 500 ng/mL
0
500 to 900 ng/mL
1
> 900 ng/mL
2
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• A score >= 6 "identified a 1-year survival." Since a higher score reflects higher risk, this score more likely identifies 1-year mortality.
Performance:
• The area under the ROC curve was 0.85.
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