cliot (version 1.0.0)

ottawa_heart_failure_risk_scale: Ottawa Heart Failure Risk Scale (OHFRS)

Description

Calculates the Ottawa Heart Failure Risk Scale to predict the risk of serious adverse events (SAEs) within 14 days in patients with acute heart failure presenting to the emergency department. SAEs include death, admission to a monitored unit, intubation/NIV, MI, or relapse requiring admission.

Usage

ottawa_heart_failure_risk_scale(stroke_tia_history, intubation_history,
                                heart_rate_arrival, oxygen_sat_arrival,
                                heart_rate_walk_test, ecg_ischemia, urea_mmol_l,
                                co2_mmol_l, troponin_elevated, nt_probnp)

Value

A list containing:

OHFRS_Score

The calculated risk score (Range 0-15).

Risk_Category

Classification (Low, Moderate, High, Very High).

Risk_Serious_Adverse_Event_14d

Estimated percentage probability of a serious adverse event within 14 days.

Arguments

stroke_tia_history

Numeric (0 or 1). History of Stroke or TIA. (1 = Yes, +1 point).

intubation_history

Numeric (0 or 1). History of intubation for respiratory distress. (1 = Yes, +2 points).

heart_rate_arrival

Numeric. Heart rate on ED arrival. (>= 110 bpm adds 2 points).

oxygen_sat_arrival

Numeric. Oxygen saturation on arrival (%). (< 90% adds 1 point).

heart_rate_walk_test

Numeric. Heart rate during 3-minute walk test (or enter >=110 if too ill to walk). (>= 110 bpm adds 1 point).

ecg_ischemia

Numeric (0 or 1). New ischemic changes on ECG. (1 = Yes, +2 points).

urea_mmol_l

Numeric. Serum Urea (BUN) level in mmol/L. (>= 12 mmol/L adds 1 point). Note: 12 mmol/L approx 33.6 mg/dL BUN.

co2_mmol_l

Numeric. Serum CO2 (Bicarbonate) level in mmol/L. (>= 35 mmol/L adds 2 points).

troponin_elevated

Numeric (0 or 1). Troponin I or T elevated to MI levels. (1 = Yes, +2 points).

nt_probnp

Numeric. NT-proBNP level in ng/L (pg/mL). (>= 5000 ng/L adds 1 point).

References

Stiell IG, Clement CM, Brison RJ, et al. A risk scoring system to identify emergency department patients with heart failure at high risk for serious adverse events. Acad Emerg Med. 2013;20(1):17-26. doi:10.1111/acem.12056 Stiell IG, Perry JJ, Clement CM, et al. Prospective and Explicit Clinical Validation of the Ottawa Heart Failure Risk Scale, With and Without Use of Quantitative NT-proBNP. Acad Emerg Med. 2017;24(3):316-327. doi:10.1111/acem.13141

Examples

# Example 1: High Risk
# Prior Intubation (+2), HR 115 (+2), Trop High (+2), Urea 15 (+1), NT-proBNP 6000 (+1)
# Score = 8
ottawa_heart_failure_risk_scale(0, 1, 115, 95, 80, 0, 15, 25, 1, 6000)

# Example 2: Low Risk
# No history, Vitals stable, Labs normal
# Score = 0
ottawa_heart_failure_risk_scale(0, 0, 80, 98, 85, 0, 5, 24, 0, 400)