Cardiovascular Medicine Book

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Dermatology

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Ottawa Heart Failure Risk Score

Aka: Ottawa Heart Failure Risk Score, Ottawa Heart Failure Risk Scale
  1. Criteria
    1. History
      1. Score 1: Stroke or Transient Ischemic Attack (TIA)
      2. Score 2: Intubation for respiratory distress
    2. Exam
      1. Score 2: Heart Rate on ED arrival >110 bpm
      2. Score 1: Oxygen Saturation<90% on arrival
      3. Score 1: Heart Rate >110 during 3 minute walk test (or unable to perform)
    3. Investigation
      1. Score 2: Electrocardiogram (EKG) with acute ischemic changes
      2. Score 1: Blood Urea Nitrogen (BUN) >33.6 mg/dl (12 mmol/L)
      3. Score 2: Serum CO2 (or serum bicarbonate) >35 mg/dl
      4. Score 2: Troponin I or Troponin T elevated consistent with Myocardial Infarction levels
      5. Score 1: NT-proBNP >5000 ng/L
  2. Interpretation: Risk of serious adverse event (death, readmission, intubation, NIPPV, ACS) in next 14 days
    1. Score 0: Low Risk (2.8% serious adverse event risk in next 14 days)
    2. Score 1-2: Moderate Risk (5.1-9.2% serious adverse event risk in next 14 days)
    3. Score 3-4: High Risk (15.9-26.1% serious adverse event risk in next 14 days)
    4. Score 5-9: Very High Risk (39.8-89.0% serious adverse event risk in next 14 days)
  3. References
    1. Stiell (2013) Acad Emerg Med 20(1): 17-26 +PMID:23570474 [PubMed]
    2. Stiell (2017) Acad Emerg Med 24(3): 326-7 +PMID:27976497 [PubMed]

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