Risk stratification scores for patients with acute heart failure in the Emergency Department: A systematic review

被引:31
|
作者
Miro, Oscar [1 ]
Rossello, Xavier [2 ,3 ,4 ]
Platz, Elke [5 ,6 ]
Masip, Josep [7 ,8 ]
Gualandro, Danielle M. [9 ,10 ,11 ]
Peacock, W. Frank [12 ]
Price, Susanna [13 ]
Cullen, Louise [14 ]
DiSomma, Salvatore [13 ]
de Oliveira Jr, Mucio Tavares [11 ]
McMurray, John J., V [14 ]
Martin-Sanchez, Francisco J. [15 ,16 ]
Maisel, Alan S. [17 ,18 ]
Vrints, Christiaan [19 ]
Cowie, Martin R. [13 ]
Bueno, Hector [3 ,20 ,21 ]
Mebazaa, Alexandre [22 ,23 ]
Mueller, Christian [9 ,10 ]
机构
[1] Univ Barcelona, Emergency Dept, Barcelona, Spain
[2] Hosp Univ Son Espases, Cardiol Dept, Palma De Mallorca, Spain
[3] Ctr Nacl Invest Cardiovasc CNIC, Madrid, Spain
[4] Hlth Res Inst Balearic Isl IdISBa, Grp Fisiopatol & Terapeut Cardiovasc, Palma De Mallorca, Spain
[5] Brigham & Womens Hosp, Dept Emergency Med, Boston, MA 02115 USA
[6] Harvard Med Sch, Boston, MA 02115 USA
[7] Univ Barcelona, Intens Care Dept, Barcelona, Spain
[8] Hosp Sanitas CIMA, Cardiol Dept, Barcelona, Spain
[9] Univ Hosp Basel, Dept Cardiol, Basel, Switzerland
[10] Univ Hosp Basel, Cardiovasc Res Inst Basel CRIB, Basel, Switzerland
[11] Univ Sao Paulo, Med Sch, Heart Inst INCOR, Sao Paulo, Brazil
[12] Baylor Coll Med, Henry JN Taub Dept Emergency Med, Houston, TX 77030 USA
[13] Imperial Coll, Royal Brompton & Harefield NHS Fdn Trust, London, England
[14] Royal Brisbane & Womens Hosp, Emergency & Trauma Ctr, Herston, Qld, Australia
[15] Hosp Clin San Carlos, Dept Emergency Med, Madrid, Spain
[16] Univ Complutense Madrid, Hosp Clin San Carlos IdISSC, Inst Invest Sanitaria, Madrid, Spain
[17] Veteran Affairs VA, Coronary Care Unit, San Diego, CA USA
[18] Veteran Affairs VA, Heart Failure Program, San Diego, CA USA
[19] Univ Antwerp, Antwerp Univ Hosp, Antwerp, Belgium
[20] Univ Complutense Madrid, Dept Cardiol, Madrid, Spain
[21] Univ Complutense Madrid, Cardiovasc Res Area, Madrid, Spain
[22] Univ Paris Diderot, Paris, France
[23] Hop Univ St Louis Lariboisiere, AP HP, Paris, France
基金
巴西圣保罗研究基金会; 美国国家卫生研究院; 瑞士国家科学基金会;
关键词
Acute heart failure; risk scores; emergency department; systematic review; ACUTE CARDIOVASCULAR CARE; IN-HOSPITAL MORTALITY; ASSOCIATION POSITION PAPER; 30-DAY ADVERSE EVENTS; OLDER PATIENTS; EUROPEAN-SOCIETY; ELDERLY-PATIENTS; AFTER-DISCHARGE; PREDICTION; CARDIOLOGY;
D O I
10.1177/2048872620930889
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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.
引用
收藏
页码:375 / 398
页数:24
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