Journal article
Risk stratification scores for patients with acute heart failure in the Emergency Department: A systematic review.
- Miró Ò Emergency Department, University of Barcelona, Spain.
- Rossello X Cardiology Department, Hospital Universitari Son Espases, Spain.
- Platz E Department of Emergency Medicine, Brigham and Women's Hospital and Harvard Medical School, USA.
- Masip J Intensive Care Department, University of Barcelona, Spain.
- Gualandro DM Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.
- Peacock WF Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, USA.
- Price S Royal Brompton and Harefield NHS Foundation Trust, Imperial College, UK.
- Cullen L Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Australia.
- DiSomma S Royal Brompton and Harefield NHS Foundation Trust, Imperial College, UK.
- de Oliveira MT Heart Institute (INCOR), University of Sao Paulo Medical School, Brazil.
- McMurray JJ Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Australia.
- Martín-Sánchez FJ Department of Emergency Medicine, Hospital Clínico San Carlos, Spain.
- Maisel AS Coronary Care Unit and Heart Failure Program, Veteran Affairs (VA) San Diego, USA.
- Vrints C Antwerp University Hospital, University of Antwerp, Belgium.
- Cowie MR Royal Brompton and Harefield NHS Foundation Trust, Imperial College, UK.
- Bueno H Centro Nacional de Investigaciones Cardiovasculares (CNIC), Spain.
- Mebazaa A University Paris Diderot, France.
- Mueller C Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.
- 2020-11-16
Published in:
- European heart journal. Acute cardiovascular care. - 2020
English
AIMS
This study aimed to systematically identify and summarise all risk scores evaluated in the emergency department setting to stratify acute heart failure patients.
METHODS AND RESULTS
A systematic review of PubMed and Web of Science was conducted including all multicentre studies reporting the use of risk predictive models in emergency department acute heart failure patients. Exclusion criteria were: (a) non-original articles; (b) prognostic models without predictive purposes; and (c) risk models without consecutive patient inclusion or exclusively tested in patients admitted to a hospital ward. We identified 28 studies reporting findings on 19 scores: 13 were originally derived in the emergency department (eight exclusively using acute heart failure patients), and six in emergency department and hospitalised patients. The outcome most frequently predicted was 30-day mortality. The performance of the scores tended to be higher for outcomes occurring closer to the index acute heart failure event. The eight scores developed using acute heart failure patients only in the emergency department contained between 4-13 predictors (age, oxygen saturation and creatinine/urea included in six scores). Five scores (Emergency Heart Failure Mortality Risk Grade, Emergency Heart Failure Mortality Risk Grade 30 Day mortality ST depression, Epidemiology of Acute Heart Failure in Emergency department 3 Day, Acute Heart Failure Risk Score, and Multiple Estimation of risk based on Emergency department Spanish Score In patients with Acute Heart Failure) have been externally validated in the same country, and two (Emergency Heart Failure Mortality Risk Grade and Multiple Estimation of risk based on Emergency department Spanish Score In patients with Acute Heart Failure) further internationally validated. The c-statistic for Emergency Heart Failure Mortality Risk Grade to predict seven-day mortality was between 0.74-0.81 and for Multiple Estimation of risk based on Emergency department Spanish Score In patients with Acute Heart Failure to predict 30-day mortality was 0.80-0.84.
CONCLUSIONS
There are several scales for risk stratification of emergency department acute heart failure patients. Two of them are accurate, have been adequately validated and may be useful in clinical decision-making in the emergency department i.e. about whether to admit or discharge.
This study aimed to systematically identify and summarise all risk scores evaluated in the emergency department setting to stratify acute heart failure patients.
METHODS AND RESULTS
A systematic review of PubMed and Web of Science was conducted including all multicentre studies reporting the use of risk predictive models in emergency department acute heart failure patients. Exclusion criteria were: (a) non-original articles; (b) prognostic models without predictive purposes; and (c) risk models without consecutive patient inclusion or exclusively tested in patients admitted to a hospital ward. We identified 28 studies reporting findings on 19 scores: 13 were originally derived in the emergency department (eight exclusively using acute heart failure patients), and six in emergency department and hospitalised patients. The outcome most frequently predicted was 30-day mortality. The performance of the scores tended to be higher for outcomes occurring closer to the index acute heart failure event. The eight scores developed using acute heart failure patients only in the emergency department contained between 4-13 predictors (age, oxygen saturation and creatinine/urea included in six scores). Five scores (Emergency Heart Failure Mortality Risk Grade, Emergency Heart Failure Mortality Risk Grade 30 Day mortality ST depression, Epidemiology of Acute Heart Failure in Emergency department 3 Day, Acute Heart Failure Risk Score, and Multiple Estimation of risk based on Emergency department Spanish Score In patients with Acute Heart Failure) have been externally validated in the same country, and two (Emergency Heart Failure Mortality Risk Grade and Multiple Estimation of risk based on Emergency department Spanish Score In patients with Acute Heart Failure) further internationally validated. The c-statistic for Emergency Heart Failure Mortality Risk Grade to predict seven-day mortality was between 0.74-0.81 and for Multiple Estimation of risk based on Emergency department Spanish Score In patients with Acute Heart Failure to predict 30-day mortality was 0.80-0.84.
CONCLUSIONS
There are several scales for risk stratification of emergency department acute heart failure patients. Two of them are accurate, have been adequately validated and may be useful in clinical decision-making in the emergency department i.e. about whether to admit or discharge.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1177/2048872620930889
- PMID 33191763
- Persistent URL
- https://sonar.ch/global/documents/231841
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