Kelder et al reported a score for the diagnosis of congestive heart failure. The authors are from multiple institutions in The Netherlands and England.
Parameters:
(1) age in years
(2) myocardial infarct, CABG or PCI
(3) therapy with a loop diuretic
(4) displaced apex beat
(5) rales basal or more
(6) irregularly irregular pulse
(7) heart murmur suggestive of mitral regurgitation
(8) pulse rate in beats per minute
(9) elevated jugular venous pressure
(10) serum NT-proBNP in pg/mL
|
Parameter |
Finding |
Points |
|
age in years |
< 60 years |
0 |
|
|
60 to 70 years |
4 |
|
|
70 to 80 years |
7 |
|
|
> 80 years |
10 |
|
MI, CABG or PCI |
no |
0 |
|
|
yes |
15 |
|
therapy with loop diuretic |
no |
0 |
|
|
yes |
10 |
|
displaced apex beat |
no |
0 |
|
|
yes |
20 |
|
rales |
no |
0 |
|
|
yes |
14 |
|
irregularly irregular pulse |
no |
0 |
|
|
yes |
11 |
|
heart murmur |
no |
0 |
|
|
yes |
10 |
|
pulse rate |
|
((heart rate) - 60) / 3 |
|
elevated jugular venous pressure |
no |
0 |
|
|
yes |
12 |
|
NT-proBNP |
< 100 |
0 |
|
|
100 to 200 |
8 |
|
|
200 to 400 |
16 |
|
|
400 to 800 |
24 |
|
|
800 to 1600 |
32 |
|
|
1600 to 3200 |
40 |
|
|
> 3200 |
48 |
total score =
= SUM(points for all 10 parameters)
Interpretation:
• minimum score: 0
• maximum score: around 196
• The higher the score the greater the risk of congestive heart failure.
X =
= (0.071646 * (score)) - 3.3812
probability of heart failure =
= 1 / (1 +EXP((-1)*X))
Performance:
• The area under the ROC curve is 0.85.
Specialty: Cardiology
