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Ottawa Heart Failure Risk Scale (OHFRS)
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.