Table 2: Risk Scores

Table 2 shows examples of HF prognostic scores which can be easily accessed and calculated, and describes the strengths and limitations of the studies used to develop these scores.

Score Name: Seattle Heart Failure Model
Population
HFrEF
Endpoint
Mortality risk at 1, 2 and 5 years with or without intervention. Mean life expectancy.
Other Considerations
Restricted to clinical trial patients with ‘severe’ HF; Lab data entry non-SI units; More than 20 variables to enter.
Access
https://depts.washington.edu/shfm/
Variables
Age, gender, NYHA class, weight, EF, SBP, ischemic etiology, diuretic dose, Na, lymphocyte count, Hgb, cholesterol, uric acid, use of ACEi/ARB/BB/aldosterone blocker/allopurinol/statins, QRS>120msec, use of device therapy

Score Name: MAGGIC Risk Score
Population
HFrEF and HFpEF
Endpoint
Mortality risk at 1 and 3 years
Other Considerations
Cohorts from many sites; missing data in the overall analysis.
Access
www.heartfailurerisk.org
Variables
Age, gender, NYHA class, diabetes, COPD, timing of diagnosis, EF, smoking, SBP, creatinine, BMI, use of beta-blocker/ACEi/ARB

Score Name: 3C-HF
Population
HFrEF and HFpEF
Endpoint
Mortality risk at 1 year
Other Considerations
Patients from centres with experience with HF management; mostly Caucasian patients; Lab data entry in non-SI units.
Access
http://www.3chf.org/site/home.php
Variables
Age, NYHA class, AF, valvular heart disease, EF, anemia, diabetes, hypertension, creatinine, use of ACEi/ARB or beta-blockers.

Score Name: BCN- Bio-HF
Population
HFrEF and HFpEF
Endpoint
Mortality risk at 1,2 and 3 years
Other Considerations
Limited to patients with chronic HF treated in HF unit in a tertiary hospital. Lab data entry in US units. Use of biomarkers improves accuracy but is optional.
Access
www.BCNBioHFcalculator.cat
Variables
Age, gender, NYHA class, Na, eGFR, Hgb, EF, diuretic dose, use of statins, beta-blockers or ACEi/ARB. Optional: hs-cTnT, ST2, Nt-pro-BNP

Score Name: EFFECT
Population
Hospitalized HFrEF and HFpEF
Endpoint
30-day and 1-year mortality
Other Considerations
Limited to hospitalized patients; missing current clinically important variables
Access
http://www.ccort.ca/Research/CHFRiskModel.aspx
Variables
Age, respiratory rate, SBP, BUN, Na, CVD, dementia, COPD, cirrhosis, cancer, Hgb

Score Name: EHMRG
Population
HFrEF and HFpEF patients presenting to the Emergency Department
Endpoint
7 day mortality
Other Considerations
Limited to patients presenting to the ER and only short-term mortality; missing current clinically important variables
Access
https://ehmrg.ices.on.ca
Variables
Age, arrival by ambulance, triage SBP, triage HR, triage O2 sat, potassium, creatinine, active cancer, metolazone, troponin. Optional: BNP

Score Name: ELAN
Population
Hospitalized HFrEF and HFpEF
Endpoint
180-day mortality
Other Considerations
Limited to hospitalized patients
Variables
Age, edema, SBP, serum sodium, serum urea, NYHA class at discharge, NT-proBNP at discharge and change in NT-proBNP

Score Name: ADHERE
Population
HFrEF and HFpEF
Endpoint
In-hospital mortality
Other Considerations
Limited to hospitalized patients
Variables
BUN, creatinine, SBP

Score Name: LACE
Population
Hospitalized patients
Endpoint
30-day mortality or readmission
Other Considerations
Limited to hospitalized patients
Variables
Length of stay, acute admission, comorbidity index, # of ED visits in last 6 months

ACEi, angiotensin-converting enzyme inhibitor;
ADHERE, Acute Decompensated Heart Failure National Registry;
ARB, angiotensin receptor blocker;
BCN bio-HF, Barcelona Bio-Heart Failure Risk Calculator;
BNP, B-type natriuretic peptide;
BUN, blood urea nitrogen;
3C-HF, Cardiac and Comorbid Conditions Heart Failure score;
COPD, chronic obstructive pulmonary disease;
CVD, cardiovascular disease;
ED, emergency department;
EF, ejection fraction;
EFFECT, Enhanced Feedback for Effective Cardiac Treatment;
EHMRG, Emergency Heart Failure Mortality Risk Grade;
ELAN-HF, European coLlaboration on Acute decompeNsated Heart Failure;
HF, heart failure;
HFpEF, heart failure with preserved ejection fraction;
HFrEF, heart failure with reduced ejection fraction;
Hgb, hemoglobin;
HR, heart rate;
hs-cTnT, high-sensitivity cardiac troponin T;
LACE, Length of stay, Acuity of Admission, Comorbidities, Emergency department visits;
MAGGIC, Meta-Analysis Global Group in Chronic Heart Failure;
NT-proBNP, N-terminal propeptide B-type natriuretic peptide;
NYHA, New York Heart Association;
SBP, systolic blood pressure; SI units, International System of Units;
ST2, suppression of tumorigenicity 2.