USING THE OTTAWA HEART FAILURE RISK SCALE

Stiell et al. recently published: Prospective and Explicit Clinical Validation of the Ottawa Heart Failure Risk Scale, With and Without Use of Quantitative NT-proBNP. AEM March 2017. Congratulations on this publication.

A discussion with the lead author is available at http://thesgem.com/2017/03/sgem170-dont-go-breaking-my-heart-ottawa-heart-failure-risk-scale/ and on updated https://emergencymedicinecases.com/episode-56-stiell-sessions-clinical-decision-rules-risk-scales/

BEC started making this scale available to ED MD’s at the point of care back  in 2014. Reason: it appeared to offer some support to our decision making process when dealing with HF patients and any valuable support I can get I’ll take. It is this original scale that has just undergone ‘Prospective and Explicit Clinical Validation’.

In May 2015 at the annual SAEM meeting (see abstract 17) and subsequently at CAEP 2015, a revised Ottawa Heart Failure Risk Scale was presented based upon univariate correlation with SAE’s for the 10 original criteria. Items such as history of stroke/TIA and history of intubation had P’s of 0.8.  As a result, Stiell et al. presented a 6 item revised scale.

BEC offered this revised scale starting late 2015 to our clinicians.  The result – MD’s are more likely to document these items on the chart.

So given this new publication, what should we incorporate into our practice, the original scale recently validated or the revised scale?

Love to have your feedback. If you can’t decide, at least do the walk test.

 

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