Hot off the Press: Prospective and Explicit Clinical Validation of the Ottawa Heart Failure Risk Scale, With and Without Use of Quantitative NT-proBNP

Summary

This prospective cohort study included patients >50 years old with dyspnea of <7 days duration, due to acute heart failure. (19) Patients too ill to be discharged were excluded. Treating physicians assessed the OHFRS approximately 2-8 hours after ED presentation. The primary outcome measured was SAE within 14 days, with SAEs including death from any cause within 30 days, admission to a monitored unit, any positive pressure ventilation, myocardial infarction, major cardiac procedure, new dialysis, or subsequent hospital admission if the patient was initially discharged from the ED. At an admission threshold of >1, the OHFRS would increase sensitivity from 71.8% to 91.8% for SAEs, but also increase admission rates. A threshold of >2 had a similar sensitivity, but decreased admissions (57.2% vs 48.3%.) Addition of NT-proBNP levels did not substantially change the results.

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