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EHMRG评分在急诊科失代偿性心力衰竭患者中的作用。

The role of the EHMRG score in patients with decompensated heart failure in the emergency department.

作者信息

Bayramoglu Burcu, Kaftanci Ismail, Tayfur Ismail, Saglam Semanur, Guven Ramazan, Altug Ertugrul, Avci Akkan

机构信息

Department of Emergency Medicine, University of Health Sciences, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Türkiye.

Department of Emergency Medicine, University of Health Sciences, Istanbul Cam and Sakura City Hospital, Istanbul, Türkiye.

出版信息

Medicine (Baltimore). 2025 Aug 22;104(34):e44027. doi: 10.1097/MD.0000000000044027.

Abstract

Heart failure is one of the common reasons for presentations to emergency departments. Heart failure, which has an increasing prevalence and high mortality rate, significantly affects the health system. Therefore, it is important to predict mortality in emergency department. This study investigated the performance of the Emergency Heart Failure Mortality Risk Grade (EHMRG) score. In this study, we retrospectively examined the data of patients who presented to our emergency department with heart failure symptoms and were diagnosed with decompensated heart failure. The ability of the EHMRG score to determine hospitalization/discharge status and predict 7- and 30-day mortality was investigated. The study included 469 patients with a mean age of 73.09 ± 11.82 years. Patients admitted to the hospital and those who died within 7 or 30 days had higher EHMRG scores compared to those who were discharged and those who survived beyond these timeframes (P < .05). The score had a sensitivity of 69.48% and a specificity of 53.91% for making hospitalization/discharge decisions; a sensitivity and specificity of 50% and 88.96%, respectively, for the prediction of 7-day mortality; and a sensitivity and specificity of 60.98% and 74.53%, respectively, for the prediction of 30-day mortality. The EHMRG score is a useful tool for assessing disease severity, making hospital admission decisions, and predicting 7- and 30-day mortality. However, it is not a discriminatory scoring system for determining whether admitted patients require ward or intensive care. The EHMRG score can be utilized without any reservations in countries where metolazone is not available.

摘要

心力衰竭是患者前往急诊科就诊的常见原因之一。心力衰竭的患病率不断上升且死亡率高,对卫生系统产生了重大影响。因此,预测急诊科患者的死亡率很重要。本研究调查了急诊心力衰竭死亡率风险分级(EHMRG)评分的性能。在本研究中,我们回顾性分析了因心力衰竭症状前来我院急诊科就诊并被诊断为失代偿性心力衰竭患者的数据。研究了EHMRG评分确定住院/出院状态以及预测7天和30天死亡率的能力。该研究纳入了469例患者,平均年龄为73.09±11.82岁。与出院患者以及在这些时间段后存活的患者相比,入院患者以及在7天或30天内死亡的患者EHMRG评分更高(P<0.05)。该评分在做出住院/出院决策时的敏感性为69.48%,特异性为53.91%;预测7天死亡率时的敏感性和特异性分别为50%和88.96%;预测30天死亡率时的敏感性和特异性分别为60.98%和74.53%。EHMRG评分是评估疾病严重程度、做出住院决策以及预测7天和30天死亡率的有用工具。然而,它不是用于确定入院患者需要病房护理还是重症监护的鉴别评分系统。在没有美托拉宗的国家,可以毫无保留地使用EHMRG评分。

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