For adults in North America, heart failure is the most common cause of hospitalization. Studies have shown that while around 40% of heart failure patients with cardiac symptoms may safely return home from a visit to an emergency department, one of every 11 patients who are discharged dies the following week.
Doctors estimate the risk of heart failure patients in the emergency department based on best clinical judgment which may include different factors depending on their prior experience. However, doctors may overestimate or underestimate the risk of death because the prognosis of heart failure patients may not be clearly apparent by a clinical assessment at the bedside. For those in very poor health or reasonably good health, physicians do a good job, but it’s the middle group where the most improvement can be made. Some of these patients are dying at home or spending days in a hospital bed that they don’t need to be in.”
—Dr. Douglas Lee, cardiologist, Peter Munk Cardiac Centre
To improve patients’ odds of survival, Dr. Lee and other cardiologists at Canada’s Peter Munk Cardiac Centre are developing smartphone and web-based applications that can help emergency department physicians determine patients’ risks in real time. Their solution, funded by the Canadian Institutes of Health Research (CIHR), is an algorithm, “Emergency Heart Failure Mortality Risk Grade” (EHMRG), which uses 10 simple indicators of potential heart trouble.
The EHMRG risk model provides a diagnostic tool that emergency physicians, consulting cardiologists, or general internists can use to help them decide if the patient’s short-term risk of death warrants continued time in hospital. Future plans include web and smartphone applications for seamless integration in the field, including in developing countries.
To view the EHMRG calculator, click http://www.ccort.ca/EHMRGTerms.aspx
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- Risk Of Death For Heart Failure Patients May Be Predicted By Emergency Department Algorithm (medicalnewstoday.com)
- Emergency department algorithm may predict risk of death for heart failure patients (medicalxpress.com)