A Comparative Study of Risk Stratifications Scores for Acute Heart Failure Patients in the Emergency Department, Egypt

Introduction: diagnosis of heart failure according to Framingham criteria which is. a) Major criteria. b) Minor criteria for establishing a definite diagnosis of HF, two major or one major and two minor criteria had to be present. In this study two risk stratification models will be used among heart failure patients who present to emergency room, The Seattle heart failure model and the Canadian predictor mortality of HF model. Aim: comparison will be done according to accuracy and easiness in predicting risk of death in 48hr and 28day from hospital admission among HF patient. Methods: This study is cross-sectional, observational study on adults presenting to the emergency department with Acute Heart Failure with short term follow up in cardiology care unit (CCU) and Cardiology inpatient ward for MACE. Patients will be divided into two groups. Each group will include 30 patients their cardiac risk determined by one of the two methods of risk stratification utilizing findings on presentation. Results: The studied patients in Canadian model was 20.0%, acute renal failure was 23.3%, stroke was 10.0%, cardiogenic shock was 36.7% and significant arrhythmia was 10.0%. While according Seattle heart failure model, 57% of the patients were at very high risk, 16.7% were at high risk, 16.7% were at intermediate risk and 10% were at low risk of mortality Conclusion: Sensitivity, specificity and +PV of Seattle heart failure model was significantly higher than Canadian predictive model with very high area under the ROC curve ( AUC) and very low standard error (SE).