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Ottawa Heart Failure Risk Scale (OHFRS)
Estimates 14-day serious adverse event risk in emergency department patients with acute heart failure.
Ottawa Heart Failure Risk Scale (OHFRS)
History of stroke or TIA
History of intubation for respiratory distress
Heart rate >= 110/min on ED arrival
Oxygen saturation < 90% on arrival
Heart rate >= 110/min during 3-minute walk test (or unable to perform)
New ischaemic ECG changes
Blood urea nitrogen > 12 mmol/L (> 33.6 mg/dL)
Serum CO2 (bicarbonate) >= 35 mmol/L
Troponin elevated to myocardial-infarction level
NT-proBNP > 5000 ng/L
Result0 points
Estimated risk of a serious adverse event (death, MI, revascularisation, intubation, non-invasive ventilation, or cardiac readmission) within 14 days: approximately 2.8 %.
- 14-day serious adverse event risk
- 2.8 %
When to use
- Supporting the admission-versus-discharge decision for emergency department patients with acute heart failure who are not otherwise clearly high- or low-risk.
Formula
Sum of: stroke/TIA history (1), prior intubation for respiratory distress (2), HR>=110 on arrival (2), SpO2<90% (1), HR>=110 on 3-minute walk test or unable to walk (1), ischaemic ECG changes (2), BUN>12 mmol/L (1), serum CO2>=35 mmol/L (2), troponin at MI threshold (2), NT-proBNP>5000 ng/L (1).
Pearls and pitfalls
- Requires a structured 3-minute walk test as part of the ED work-up.
- Developed to standardise a disposition decision that otherwise varies widely between clinicians.