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Score of Kinugasa et al for Predicting the Risk of In-Hospital Mortality for an Elderly Patient with Acute Decompensated Heart Failure

Purpose: To evaluate an elderly adult patient admitted for acute decompensated heart failure using the risk score of Kinugasa et al.

Description

Kinugasa et al developed a simple risk score for predicting in-hospital mortality for an elderly Japanese patient with acute decompensated heart failure. This can help to identify a patient who may benefit from more aggressive management. The authors are from Tottori University in Yonago, Japan.


Patient selection: elderly patient (> 65 years old) hospitalized for acute decompensated heart failure

 

Parameters:

(1) history of previous hospitalizations for heart failure

(2) serum sodium in mmol/L

(3) albumin in g/dL

(4) serum BUN in mg/dL

(5) BNP in pg/mL

 

Parameter

Finding

Points

history of previous hospital admissions for heart failure

no

0

 

yes

2

serum sodium

> 138 mmol/L

0

 

<= 138 mmol/L

2

serum albumin

> 3.2 g/dL

0

 

<= 3.2 g/dL

2

serum BUN

< 35 mg/dL

0

 

>= 35 mg/dL

2

BNP

< 980 pg/mL

0

 

>= 980 pg/mL

2

 

total score =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 11

• The higher the score the greater the likelihood of in-hospital mortality.

 

Total Score

Risk Group

Mortality Rate

0 to 4

low

1.6%

5 to 7

moderate

16%

8 to 11

high

42%

 

Performance:

• The area under the ROC curve is 0.86.

 

Limitations:

• The laboratory method used will affect the cutoffs, especially for BNP.


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Specialty

Objective

ICD-10