Heart failure & cardiomyopathiesDiagnostic or prognostic study
Prospective Validation and Implementation Pilot Study of an Emergency Department Heart Failure Risk Stratification Tool
- Prospective validation study and implementation pilot
- multicentre
- 21 community emergency department (EDs)
- 2-ED pilot
Authors' conclusion
STRIDE-HF maintained high predictive accuracy for 30-day SAE in prospective validation in this large, diverse, multicenter cohort; the use of risk estimates in real time safely identified low-risk patients appropriate for discharge.
Study context
- Population
- Patients in the ED with acute HF, 21 community EDs, January 1, 2023, to December 31, 2023845 in pilot
- Participants
- 13,274 patients
- Outcome
- 30-day serious adverse event:
- Mortality
- Cardiopulmonary resuscitation
- Intra-aortic balloon pump
- Intubation
- New dialysis
- MI
- Coronary revascularization
- Follow-up
- 30 days
Performance
As reported in the abstract
Prediction of 30-day SAE (prospective validation)
| Test or model | Sensitivity among low-risk patients | Area under the receiver operator curve (AUROC) | Area under the precision recall curve (AUPRC) |
|---|---|---|---|
| STRIDE-HF | 97.6% (95% CI: 96.8%-98.2%) | 0.75 (95% CI: 0.74-0.76) | 0.43 (95% CI: 0.39-0.44) |
- 30-day serious adverse event (SAE) rate, very-low-risk
- 3.4%
- 30-day SAE rate, low-risk
- 6.7%
- 30-day mortality, very-low-risk
- <1%
- 30-day mortality, low-risk
- <2%
Further findings
Risk category distribution
- Very low risk
- 11.4%
- Low risk
- 24.8%
- Moderate risk
- 31.9%
- High risk
- 31.9%
Safety
30-day SAE among very-low-risk patients discharged (pilot)
- Very-low-risk discharged patients with a 30-day SAE
- 0
- pilot n = 845
Original publication
Prospective Validation and Implementation Pilot Study of an Emergency Department Heart Failure Risk Stratification Tool. JACC Heart Fail. Published 9 April 2025. doi:10.1016/j.jchf.2025.01.018
Summarised from the published abstract; every number is checked against it