Syeeda S Farruque

models@cambiocds.com

© Cambio Healthcare Systems

The Emergency Heart Failure Mortality Risk Grade (EHMRG) is used to provide an assessment of the mortality of CHF patients coming into A&R for high risk of mortality within 7 days of admission.

As CHF patients often suffer from symptoms that would in other circumstances alert healthcare professionals about potential mortality risks on their own, this tool helps to provide a screening tool within the CHF cohort of patients to ascertain those patients that would be safe to go home and those that would need extra monitoring at hospital. There are 10 variables used in the tool which are scored in various ways with differing weights - often using the numerical value of the variable itself and these are then summed to create a total score: Age (score is generated by multiplying the age by 2) Sys BP (Muliplying the SBP by -1 but only upto a maximum of 160mmHg - values above that generate the same -160 maximum score) Heart rate (HR) - multiply by 1 to a minimum of 80 and a maximum of 120 BPM O2 saturation - multiply by -2 and to a maximum of 92mmHg Creatinine (Cr) - multiply by 20 [range: 0.7- 1.3 mg/dL ] K+ (Potassium): <4 (scores 5); 4-4.5 (scores 0) and >4.5 (scores 30) in mEq/L Troponin positive: No = 0; Yes = 60 Transported by EMS (Emergency Services) = 60 Active cancer = 45 On outpatient metolazone (at home) = 60 An adjustment factor of 12 is also added to bring the median score to approach 0 Total scores can be negative and score grading/interpretations are more easily derived from a risk graph which is outlined in (1)

Not intended to be used with dialysis patients

Ref. 1: Lee DS, Stitt A, Austin PC, Stukel TA, Schull MJ, Chong A, Newton GE, Lee JS, Tu JV. Prediction of heart failure mortality in emergent care: a cohort study. Ann Intern Med. 2012 Jun 5;156(11):767-75, W-261, W-262. doi: 10.7326/0003-4819-156-11-201206050-00003. PubMed PMID: 22665814.

OBSERVATION.emergency_hf_mortality_risk_grade.v1, OBSERVATION.basic_demographic.v1, OBSERVATION.blood_pressure.v2, OBSERVATION.pulse.v2, OBSERVATION.lab_test-blood_gases.v1, OBSERVATION.lab_test-urea_and_electrolytes.v1