Heart failure & cardiomyopathies
The HEARTRISK6 Scale: Predicting Short-Term Serious Outcomes in Emergency Department Acute Heart Failure Patients
Authors' conclusion
Using 3 large prospectively collected datasets, we created a concise and sensitive risk scale for patients with AHF in the ED.
Study context
- Population
- Emergency department (ED) patients requiring treatment for acute heart failure (AHF)
- Participants
- 2,246 patients3 cohorts
- Exposure
- HEARTRISK6 admission thresholds ≥1 vs ≥2
- Outcome
- Short-term serious outcomes (SSO): death <30 days, intubation or NIV, MI, or relapse to ED <14 days
Methodological detailspooled prospective cohorts, 10 tertiary care hospital EDs, logistic regression with AIC-based step-down, bootstrapped internal validation
- Pooled prospective cohorts
- 10 tertiary care hospital EDs
- Logistic regression with AIC-based step-down
- Bootstrapped internal validation
Main finding
As reported in the abstract
SSO prediction
| Strategy | Sensitivity | Specificity |
|---|---|---|
| Threshold ≥1 | 88.3% (95% CI: 83.9%-91.8%)Sensitivity on a scale from 0 to 100 percent | 24.7% (95% CI: 22.8%-26.7%)Specificity on a scale from 0 to 100 percent |
| Threshold ≥2 | 71.5% (95% CI: 65.9%-76.7%)Sensitivity on a scale from 0 to 100 percent | 50.1% (95% CI: 47.9%-52.4%)Specificity on a scale from 0 to 100 percent |
Sensitivity
Threshold ≥188.3% (95% CI: 83.9%-91.8%)
Threshold ≥271.5% (95% CI: 65.9%-76.7%)
Sensitivity on a scale from 0 to 100 percentSpecificity
Threshold ≥124.7% (95% CI: 22.8%-26.7%)
Threshold ≥250.1% (95% CI: 47.9%-52.4%)
Specificity on a scale from 0 to 100 percent- SSOs in cohort
- 281 (12.5%)
- Deaths
- 70 (3.1%)
Observational data: associations, not effects.
Original publication
The HEARTRISK6 Scale: Predicting Short-Term Serious Outcomes in Emergency Department Acute Heart Failure Patients. JACC Adv. Published 24 May 2024. doi:10.
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