SpringerLink
Log in

Evaluation of the HEFESTOS scale to predict outcomes in emergency department acute heart failure patients

  • EM - ORIGINAL
  • Published:
Internal and Emergency Medicine Aims and scope Submit manuscript

Abstract

The HEFESTOS scale was developed in 14 Spanish primary care centres and validated in 9 primary care centres of other European countries. It showed good performance to predict death/hospitalisation during the first 30 days after an episode of acute heart failure (AHF), with c-statistics of 0.807/0.730 in the derivation/validation cohorts. We evaluated this scale in the emergency department (ED) setting, comparing it to the EHMRG and MEESSI scales in the ED and the EFFECT and GWTG scales in hospitalised patients, to predict 30-day outcomes, including death and hospitalisation. Consecutive AHF patients were enrolled in 34 Spanish EDs in January–February 2016, 2018, and 2019 with variables needed to calculate outcome scores. Thirty-day hospitalisation/death (together and separately) and post-discharge combined adverse event (ED revisit or hospitalisation for AHF or all-cause death) were determined for patients discharged home after ED care. Predictive capacity was assessed by c-statistic with 95% confidence intervals. Of 10,869 patients, 4,044 were included (median age: 83 years, 54% women). The performance of HEFESTOS was modest for 30-day hospitalisation/death, c-statistic=0.656 (0.637-0.675), hospitalisation, 0.650 (0.631-0.669), and death, 0.610 (0.576-0.644). Of 1,034 patients with scores for the 5 scales, HEFESTOS had the numerically highest c-statistic for hospitalisation/death at 30 days, 0.666 (0.627-0.704), vs. MEESSI= 0.650 (0.612-0.687, p=0.51), EFFECT=0.633 (0.595-0.672, p=0.21), GWTG=0.618 (0.578-0.657, p=0.06) and EHMRG=0.617 (0.577-0.704, p=0.07). Similar modest performances were observed for predicting hospitalisation [ranging from HEFESTOS=0.656 (0.618-0.695) to GWTG=0.603 (0.564-0.643)]. Conversely, prediction of 30-day death was good with the MEESSI=0.787 (0.728-845), EFFECT=0.754 (0.691-0.818) and GWTG=0.749 (0.689-0.809) scales, and modest with EHMRG=0.649 (0.581-0.717) and HEFESTOS=0.610 (0.538-0.683). Although the HEFESTOS scale was numerically better for predicting 30-day hospitalisation/death in ED AHF patients, its modest performance precludes routine use. Only 30-day mortality was adequately predicted by some scales, with the MEESSI achieving the best results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (United Kingdom)

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M et al (2022) 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the european society of cardiology (ESC) with the special contribution of the heart failure association (HFA) of the ESC. Eur J Heart Fail 24(1):4–131. https://doi.org/10.1002/ejhf.2333

    Article  PubMed  Google Scholar 

  2. Santas E, Valero E, Mollar A, García-Blas S, Palau P et al (2017) Burden of recurrent hospitalizations following an admission for acute heart failure: preserved versus reduced ejection fraction. Rev Esp Cardiol 70:239–246. https://doi.org/10.1016/j.rec.2016.06.021

    Article  PubMed  Google Scholar 

  3. Llorens P, Escoda R, Miró Ò, Herrero-Puente P, Martín-Sánchez FJ et al (2015) Characteristics and clinical course of patients with acute heart failure and the therapeutic measures applied in Spanish emergency departments: based on the EAHFE registry (epidemiology of acute heart failure in emergency departments). Emergencias 27:11–22

    PubMed  Google Scholar 

  4. Miró O, Sánchez C, Gil V, Repullo D, García-Lamberechts EJ, González Del Castillo J et al (2022) Organización y práctica clínica actual en los servicios de urgencias españoles en la atención a los pacientes con insuficiencia cardiaca aguda. Emergencias 34:85–94

    PubMed  Google Scholar 

  5. Miró Ò, Levy PD, Möckel M, Pang PS, Lambrinou E, Bueno H et al (2017) Disposition of emergency department patients diagnosed with acute heart failure: an international emergency medicine perspective. Eur J of Emerg Med 24(1):2–12. https://doi.org/10.1097/MEJ.0000000000000411

    Article  Google Scholar 

  6. Miró Ò, Rossello X, Gil V, Martín-Sánchez FJ, Llorens P, Herrero-Puente P et al (2017) Predicting 30-day mortality for patients with acute heart failure in the emergency department: a cohort study. Ann Intern Med. 167:698–705. https://doi.org/10.7326/M16-2726 (on behalf of the ICA-SEMES Research Group)

    Article  PubMed  Google Scholar 

  7. Miró Ò, Gil V, Rosselló X, Martín-Sánchez FJ, Llorens P, Jacob J, Herrero P et al (2019) Patients with acute heart failure discharged from the emergency department and classified as low risk by the MEESSI score (multiple risk estimate based on the Spanish emergency department scale): prevalence of adverse events and predictability. Emergencias 31:5–14

    PubMed  Google Scholar 

  8. Lee DS, Stitt A, Austin PC, Stukel TA, Schull MJ, Chong A et al (2012) Prediction of heart failure mortality in emergent care: a cohort study. Ann Intern Med 156:767–775. https://doi.org/10.7326/0003-4819-156-11-201206050-00003

    Article  PubMed  Google Scholar 

  9. Storrow AB, Jenkins CA, Self WH, Alexander PT, Barrett TW, Han JH et al (2014) The burden of acute heart failure on U.S emergency departments. JACC Heart Fail 2:269–77. https://doi.org/10.1016/j.jchf.2014.01.006

    Article  PubMed  PubMed Central  Google Scholar 

  10. Stiell IG, Clement CM, Brison RJ, Rowe BH, Borgundvaag B, Aaron SD et al (2013) A risk scoring system to identify emergency department patients with heart failure at high risk for serious adverse events. Acad Emerg Med 20:17–26. https://doi.org/10.1111/acem.12056

    Article  PubMed  Google Scholar 

  11. Diercks DB, Fonarow GC, Kirk JD, Emermam CL, Hollander JE, Weber JE et al (2008) Risk stratification in women enrolled in the acute decompensated heart failure national registry emergency module (ADHERE-EM). Acad Emerg Med 2008(15):151–8. https://doi.org/10.1111/j.1553-2712.2008.00030.x (for the ADHERE scientific advisory committee and investigators)

    Article  Google Scholar 

  12. Miró Ò, Rossello X, Gil V, Martín-Sánchez FJ, Llorens P, Herrero-Puente P et al (2019) Analysis of how emergency physicians’ decisions to hospitalize or discharge patients with acute heart failure match the clinical risk categories of the MEESSI-AHF scale. Ann Emerg Med 2019(74):204–215. https://doi.org/10.1016/j.annemergmed.2019.03.010 (ICA-SEMES Research Group)

    Article  Google Scholar 

  13. Álvarez-García J, Ferrero-Gregori A, Puig T, Vázquez R, Delgado J, Pascual-Figal D et al (2015) A simple validated method for predicting the risk of hospitalization for worsening of heart failure in ambulatory patients: the Redin-SCORE. Eur J Heart Fail 17:818–827. https://doi.org/10.1002/ejhf.287 (on behalf of the investigators of the Spanish Heart Failure Network)

    Article  PubMed  Google Scholar 

  14. Verdú-Rotellar JM, Abellana R, Vaillant-Roussel H, Jevsek LG, Assenova R, Lazic DK et al (2022) Risk stratification in heart failure decompensation in the community: HEFESTOS score. ESC Heart Fail 9(1):606–13. https://doi.org/10.1002/ehf2.13707 (HEFESTOS group)

    Article  PubMed  Google Scholar 

  15. Gil V, Miró Ò, Schull MJ, Llorens P, Herrero-Puente P, Jacob J et al (2018) Emergency heart failure mortality risk grade score performance for 7-day mortality prediction in patients with heart failure attended at the emergency department: validation in a Spanish cohort. Eur J Emerg Med 25(3):169–177. https://doi.org/10.1097/MEJ.0000000000000422

    Article  PubMed  Google Scholar 

  16. Lee DS, Austin PC, Rouleau JL, Liu PP, Naimark D, Tu JV (2003) Predicting mortality among patients hospitalized for heart failure: derivation and validation of a clinical model. JAMA 290:2581–2587. https://doi.org/10.1001/jama.290.19.2581

    Article  CAS  PubMed  Google Scholar 

  17. Peterson PN, Rumsfeld JS, Liang L, Albert NM, Hernandez AF, Peterson ED et al (2010) A validated risk score for in-hospital mortality in patients with heart failure from the American heart association get with the guidelines program. Circ Cardiovasc Qual Outcomes 3:25–32. https://doi.org/10.1161/CIRCOUTCOMES.109.854877

    Article  PubMed  Google Scholar 

  18. Lorenzo-Hernández M, Sanchís J (2022) La organización asistencial de la insuficiencia cardiaca descompensada en España: ¿dónde estamos? management of acute decompensated heart failure in Spain: where are we now? Emergencias 34:81–82

    PubMed  Google Scholar 

  19. Miró Ò, Peacock FW, McMurray JJ, Bueno H, Christ M, Maisel AS et al (2017) Acute heart failure study group of the ESC acute cardiovascular care association. european society of cardiology-acute cardiovascular care association position paper on safe discharge of acute heart failure patients from the emergency department. Eur Heart J Acute Cardiovasc Care 6:311–320. https://doi.org/10.1177/2048872616633853

    Article  PubMed  Google Scholar 

  20. Ho KKL, Anderson KM, Kannel WB, Grosssman W, Levy D (1993) Survival after the onset of congestive heart failure in framingham heart study subjects. Circulation 88:107–115. https://doi.org/10.1161/01.cir.88.1.107

    Article  CAS  PubMed  Google Scholar 

  21. Miró Ò, Rossello X, Platz E, Masip J, Gualandro DM, Frank Peacock WF et al (2020) Study group on acute heart failure of the acute cardiovascular care association of the european society of cardiology risk stratification scores for patients with acute heart failure in the emergency department: a systematic review. Eur Heart J Acute Cardiovasc Care 9(5):375–398. https://doi.org/10.1177/2048872620930889

    Article  PubMed  Google Scholar 

  22. Lagu T, Pekow PS, Shieh MS, Mihaela M, Pack QR, Kashef MA et al (2016) Validation and comparison of seven mortality prediction models for hospitalized patients with acute decompensated heart failure. Circ Heart Fail 9:e002912. https://doi.org/10.1161/CIRCHEARTFAILURE.115.002912

    Article  PubMed  Google Scholar 

  23. Rider I, Sorensen M, Brady WJ, Gottlieb M, Benson S, Koyfman A et al (2021) Disposition of acute decompensated heart failure from the emergency department: an evidence-based review. Am J Emerg Med 50:459–465. https://doi.org/10.1016/j.ajem.2021.08.070

    Article  PubMed  Google Scholar 

  24. Miró Ò, Rosselló X, Gil V, Martín-Sánchez FJ, Llorens P, Herrero P et al (2019) The usefulness of the meessi score for risk stratification of patients with acute heart failure at the emergency department. Rev Esp Cardiol 72(3):198–207. https://doi.org/10.1016/j.rec.2018.05.002

    Article  PubMed  Google Scholar 

  25. Wussler D, Kozhuharov N, Sabti Z et al (2019) External validation of the MEESSI acute heart failure risk score: a cohort study. Ann Intern Med 170:248–256. https://doi.org/10.7326/M18-1967

    Article  PubMed  Google Scholar 

  26. Lee DS, See JS, Schull MJ, Borgundvaag B, Edmonds ML, Ivankovic M et al (2019) Prospective validation of the emergency heart failure mortality risk grade for acute heart failure. The ACUTE Study Circulation. 139:1146–1156. https://doi.org/10.1161/CIRCULATIONAHA.118.035509

    Article  PubMed  Google Scholar 

  27. Greig D, Austin PC, Zhou L et al (2014) Ischemic electrocardiographic abnormalities and prognosis in decompensated heart failure. Circ Heart Fail 7:986–993. https://doi.org/10.1161/CIRCHEARTFAILURE.114.001460

    Article  PubMed  Google Scholar 

  28. Lyle M, Wan SH, Murphree D, Bennett C, Wiley BM, Barsness G, Redfield M, Jentzer J (2020) Predictive value of the get with the guidelines heart failure risk score in unselected cardiac intensive care unit patients. J Am Heart Assoc 9:e012439. https://doi.org/10.1161/JAHA.119.012439

    Article  PubMed  PubMed Central  Google Scholar 

  29. Martín-Sánchez FJ, Parra Esquivel P, Llopis García G, González Del Castillo J, Rodríguez Andrada E, Espinosa B et al (2021) Resultados a 30 días en los pacientes mayores frágiles con insuficiencia cardiaca aguda dados de alta desde urgencias o sus unidades vinculadas que cumplen los criterios de alto riesgo del estudio DEED FRAIL-AHF. Emergencias 33:165–173

    PubMed  Google Scholar 

  30. Llorens P, Manito Lorite N, Manzano Espinosa L et al (2015) Consensus for improving the care of patients with acute heart failure. Emergencias 27:245–266

    PubMed  Google Scholar 

  31. Riegel B, Moser DK, Anker SD et al (2009) State of the science: promoting self-care in persons with heart failure: a scientific statement from the American heart association. Circulation 120:1141–63. https://doi.org/10.1161/CIRCULATIONAHA.109.192628

    Article  PubMed  Google Scholar 

  32. Lee DS, Schull MJ, Alter DA, Austin PC, Laupacis A, Chong A et al (2010) Early deaths in patients with heart failure discharged from the emergency department: a populationbased analysis. Circ Heart Fail 3:228–235. https://doi.org/10.1161/CIRCHEARTFAILURE.109.885285

    Article  PubMed  Google Scholar 

  33. Kapoor JR, Kapoor R, Ju C et al (2016) Precipitating clinical factors, heart failure characterization, and outcomes in patients hospitalized with heart failure with reduced, borderline, and preserved ejection fraction. JACC Heart Fail 4:464–72. https://doi.org/10.1016/j.jchf.2016.02.017

    Article  PubMed  Google Scholar 

  34. Verdu-Rotellar JM, Vaillant-Roussel H, Abellana R et al (2020) Precipitating factors of heart failure decompensation, short-term morbidity and mortality in patients attended in primary care. Scand J Prim Health Care 38:473–80. https://doi.org/10.1080/02813432.2020.1844387

    Article  PubMed  PubMed Central  Google Scholar 

  35. Long B, Koyfman A, Gottlieb M (2018) Management of Heart Failure in the emergency department setting: an evidence-based review of the literature. J Emerg Med 55(5):635–646. https://doi.org/10.1016/j.jemermed.2018.08.002

    Article  PubMed  Google Scholar 

  36. García-Álvarez A (2021) Seguridad e identificación de factores modificables en los pacientes mayores dados de alta desde urgencias por insuficiencia cardiaca aguda. Emergencias 33:161–162

    PubMed  Google Scholar 

  37. Blecker S, Ladapo JA, Doran KM, Goldfeld KS, Katz S (2014) Emergency department visits for heart failure and subsequent hospitalization or observation unit admission. Am Heart J 168:901. https://doi.org/10.1016/j.ahj.2014.08.002

    Article  PubMed  PubMed Central  Google Scholar 

  38. Michaud AM, Parker SIA, Ganshorn H, Ezekowitz JA (2017) McRae AD. Prediction of early adverse events in emergency department patients with acute heart failure: a systematic review. Can J Cardiol 34:168–179. https://doi.org/10.1016/j.cjca.2017.09.004

    Article  PubMed  Google Scholar 

  39. Aguilar GS (2020) Importancia de la fragilidad física en el momento del ingreso en el pronóstico de la insuficiencia cardiaca. Emergencias 32:147–148

    Google Scholar 

  40. Zsilinszka R, Mentz RJ, DeVore AD, Eapen ZJ, Pang PS, Hernandez AF (2017) Acute Heart Failure: Alternatives to Hospitalization. JACC Heart Fail 5:329–336. https://doi.org/10.1016/j.jchf.2016.12.014

    Article  PubMed  Google Scholar 

  41. Santas E, Núñez J (2020) Disfunción renal en la insuficiencia cardiaca aguda: una misma cara de diferentes monedas. Emergencias 32:311–313

    PubMed  Google Scholar 

  42. Gargani L, Pang PS, Frassi F, Miglioranza MH, Din FLi, Landi P, Picano E. (2015) Persistent pulmonary congestion before discharge predicts rehospitalization in heart failure: a lung ultrasound study. Cardiovasc Ultrasound. https://doi.org/10.1186/s12947-015-0033-4

    Article  PubMed  PubMed Central  Google Scholar 

  43. Kobayashi M et al (2019) Mid-term prognostic impact of residual pulmonary congestion assessed by radiographic scoring in patients admitted for worsening heart failure. Int J Cardiol 15(289):91–98. https://doi.org/10.1016/j.ijcard.2019.01.091

    Article  Google Scholar 

  44. Vauthier C, Chabannon M, Markarian T, Taillandy Y, Guillemet K, Krebs H et al (2021) Rendimiento de un algoritmo basado en ecografía cardiopulmonar a la cabecera del paciente (POCUS)para el diagnóstico de insuficiencia cardiaca aguda en pacientes que consultan en urgencias por disnea aguda. Emergencias 33:441–446

    PubMed  Google Scholar 

  45. Thibodeau JT, Drazner MH (2018) The role of the clinical examination in patients with heart failure. JACC Heart Fail 6(7):543–551. https://doi.org/10.1016/j.jchf.2018.04.005

    Article  PubMed  Google Scholar 

  46. Benito Lozano M, Miró Ò, Llorens P, Travería L, Pavón Monzó JM, Noval de la Torre A et al (2021) Características clínicas, asistenciales y evolutivas de la insuficiencia cardiaca aguda en el clima subtropical: resultados del estudio CANAR-ICA. Emergencias 33:413–420

    PubMed  Google Scholar 

  47. Altibi AM, Prousi G, Agarwal M, Shah M, Tripathi B, Ram P, Patel B (2021) Readmission-free period and in-hospital mortality at the time of first readmission in acute heart failure patients-NRD-based analysis of 40,000 heart failure readmissions. Heart Fail Rev 26:57–64. https://doi.org/10.1007/s10741-019-09912-z

    Article  PubMed  Google Scholar 

  48. Llauger L, Jacob J, Moreno LA, Aguirre A, Martín-Mojarro E, Romero-Carrete JC et al (2020) Factores asociados con el empeoramiento de la función renal durante un episodio de insuficiencia cardiaca aguda y su relación con la mortalidad a corto y largo plazo: estudio EAHFE—EFRICA. Emergencias 32:332–339

    PubMed  Google Scholar 

Download references

Acknowledgements

This study was partially supported by competitive grants from the Instituto de Salud Carlos III supported with funds from the Spanish Ministry of Health and FEDER (PI18/00393). The ICA-Research Group has received unrestricted funding from Novartis and Orion Pharma. José María Verdú-Rotellar and HEFESTOS group received grants from the Carlos III Institute of Health, Ministry of Economy and Competitiveness (Spain), awarded on the 2014 call under the Health Strategy Action 2013-2016, within the National Research Program oriented to Societal Challenges, within the Technical, Scientific and Innovation Research National Plan 2013-2016, co-funded with European Union ERDF funds [PI14/00583] and The European General Practice Research Network (EGPRN) [HP/2015.036]. We are very grateful for the great professionalism of Alicia Díaz in the data management of the EAHFE Registry. The design of the study, patient inclusion, data analysis, discussion and final conclusions were exclusively carried out by the authors with no participation of the granters. Marta Fuentes, Cristina Gil (Hospital Universitario de Salamanca), Héctor Alonso, Enrique Pérez-Llantada (Hospital Marqués de Valdecilla de Santander), Francisco Javier Martín-Sánchez, Guillermo Llopis García, Mar Suárez Cadenas (Hospital Clínico San Carlos de Madrid), Òscar Miró, Víctor Gil, Rosa Escoda, Sira Aguiló, Carolina Sánchez (Hospital Clínic de Barcelona), Javier Millán (Hospital Politénic La Fe de Valencia), José Pavón, Nayra Cabrera González (Hospital Dr. Negrín de Las Palmas de Gran Canaria), Antonio Noval (Hospital Insular de Las Palmas de Gran Canaria), Rafael Calvo Rodríguez, Juan Antonio Vega Reyes (Hospital Reina Sofía de Córdoba), María Luisa López-Grima, Amparo Valero, María Ángeles Juan (Hospital Dr. Peset de Valencia), Alfons Aguirre, Silvia Mínguez Masó, Lluis Enric Castillero Díaz (Hospital del Mar de Barcelona), María Isabel Alonso, Francisco Ruiz (Hospital de Valme de Sevilla), José Miguel Franco (Hospital Miguel Servet de Zaragoza), Ana Belén Mecina (Hospital de Alcorcón de Madrid), Josep Tost, Marta Berenguer, Ruxandra Donea (Consorci Sanitari de Terrassa), Susana Sánchez Ramón, Virginia Carbajosa Rodríguez (Hospital Universitario Rio Hortega de Valladolid), Pascual Piñera, José Andrés Sánchez Nicolás, Paula Lázaro Aragüés (Hospital Reina Sofía de Murcia), Raquel Torres Garate, Esther Álvarez Rodríguez (Hospital Severo Ochoa de Madrid), Aitor Alquézar-Arbé, Miguel Alberto Rizzi, Sergio Herrera (Hospital de la Santa Creu y Sant Pau de Barcelona), Javier Jacob, Alex Roset, Irene Cabello, Antonio Haro (Hospital Universitari de Bellvitge de Barcelona), Fernando Richard, José María Álvarez Pérez, María-Pilar López-Diez (Hospital Universitario de Burgos), Pablo Herrero Puente, Joaquín Vázquez Álvarez, Belén Prieto García, María García García, Marta Sánchez González (Hospital Universitario Central de Asturias de Oviedo), Pere Llorens, Inmaculada Jiménez, Néstor Hernández , Benjamín Brouzet, Begoña Espinosa, Adriana Gil-Rodrigo, Tamara García, María Dolores Jódar (Hospital General Universitario Dr. Balmis de Alicante), Juan Antonio Andueza (Hospital General Universitario Gregorio Marañón de Madrid), Rodolfo Romero, Virginia Álvarez, Maite del Cerro, Nerea López, Silvia Odeh, Marta Merlo (Hospital Universitario de Getafe de Madrid), Martín Ruíz (Hospital de Henares de Madrid), María Teresa Lorca Serralta, Luis Ernesto Calderón Jave (Hospital del Tajo de Madrid), Beatriz Amores Arriaga, Beatriz Sierra Bergua (Hospital Clínico Lozano Blesa de Zaragoza), Enrique Martín Mojarro, Brigitte Silvana Alarcón Jiménez (Hospital Sant Pau i Santa Tecla de Tarragona), Lisette Travería Bécquer, Guillermo Burillo (Hospital Universitario de Canarias de Tenerife), Lluís Llauger García, Gerard Corominas LaSalle. (Hospital Universitari de Vic de Barcelona), Carmen Agüera Urbano, Ana Belén García Soto, Elisa Delgado Padial (Hospital Costa del Sol de Marbella de Málaga), Ester Soy Ferrer, María Adroher Múñoz (Hospital Josep Trueta de Girona). José Manuel Garrido (Hospital Virgen Macarena de Sevilla), Francisco Javier Lucas-Imbernón (Hospital General Universitario de Albacete), Rut Gaya (Hospital Juan XXIII de Tarragona), Carlos Bibiano, María Mir, Beatriz Rodríguez (Hospital Universitario Infanta Leonor de Madrid), José Luis Carballo (Complejo Hospitalario Universitario de Ourense), Esther Rodríguez-Adrada, Belén Rodríguez Miranda, Monika Vicente Martín (Hospital Rey Juan Carlos de Móstoles de Madrid). Pere Coma Casanova, Joan Espinach Alvarós (Hospital San Joan de Deu de Martorell, Barcelona)

Author information

Author notes

  1. Adriana Gil-Rodrigo and José María Verdú-Rotellar contributed equally to this manuscript and should be considered as first authors.

Authors and Affiliations

  1. Emergency Department, Short Stay Unit and Hospitalization at Home Unit, Dr, Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain

    Adriana Gil-Rodrigo, Nicole Ivars-Obermeier, Begoña Espinosa & Pere Llorens

  2. Unitat de Suport a La Recerca de Barcelona, Fundació Institut Universitari Per a La Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), Catalan Institute of Health, Pompeu Fabra University, Barcelona, Spain

    José María Verdú-Rotellar & Miguel-Ángel Muñoz

  3. Emergency Department, Clinic Barcelona Hospital University, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), University of Barcelona, c/ Villarroel 170, 08036, Barcelona, Catalonia, Spain

    Víctor Gil & Òscar Miró

  4. Emergency Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain

    Aitor Alquézar

  5. Emergency Department, Hospital Universitari de Vic, Barcelona, Catalonia, Spain

    Lluís Llauger

  6. Emergency Department, Central University Hospital of Asturias, Oviedo, Spain

    Pablo Herrero-Puente

  7. Emergency Department, Hospital Universitari de Bellvitge, l’Hospitalet de Llobregat, Barcelona, Catalonia, Spain

    Javier Jacob

  8. Unitat de Bioestadistica del Departament de Fonaments Clínics, Medical School, University of Barcelona, Barcelona, Catalonia, Spain

    Rosa Abellana

  9. Emergency Department, Healthcare University Complex of Burgos, Burgos, Spain

    María-Pilar López-Díez

  10. Emergency Department, Infanta Leonor University Hospital, Madrid, Spain

    Beatriz Rodríguez

  11. Emergency Department, University Hospital of Salamanca, Salamanca, Spain

    Marta Fuentes

  12. Emergency Department, Consorci Hospitalari de Terrassa, Barcelona, Catalonia, Spain

    Josep Tost

  13. Emergency Department, Doctor Peset University Hospital, Valencia, Spain

    M. Luisa López-Grima

  14. Emergency Department, University Hospital of Getafe, Universidad Europea, Madrid, Spain

    Rodolfo Romero

  15. Cardiology Department, University Hospital of Basel, Cardiovascular Research Institute Basel, Basel, Switzerland

    Christian Müller

  16. Emergency Department, Baylor School of Medicine, Houston, TX, USA

    WFrank Peacock

  17. The GREAT Network, Rome, Italy

    Christian Müller, WFrank Peacock & Òscar Miró

Authors
  1. Adriana Gil-Rodrigo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. José María Verdú-Rotellar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Víctor Gil
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Aitor Alquézar
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lluís Llauger
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Pablo Herrero-Puente
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Javier Jacob
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Rosa Abellana
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Miguel-Ángel Muñoz
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. María-Pilar López-Díez
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Nicole Ivars-Obermeier
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Begoña Espinosa
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Beatriz Rodríguez
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Marta Fuentes
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Josep Tost
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. M. Luisa López-Grima
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Rodolfo Romero
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Christian Müller
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. WFrank Peacock
    View author publications

    You can also search for this author in PubMed Google Scholar

  20. Pere Llorens
    View author publications

    You can also search for this author in PubMed Google Scholar

  21. Òscar Miró
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

the ICA-SEMES Group

  • Marta Fuentes
  • , Cristina Gil
  • , Héctor Alonso
  • , Enrique Pérez-Llantada
  • , Francisco Javier Martín-Sánchez
  • , Guillermo Llopis García
  • , Mar Suárez Cadenas
  • , Òscar Miró
  • , Víctor Gil
  • , Rosa Escoda
  • , Sira Aguiló
  • , Carolina Sánchez
  • , Javier Millán
  • , José Pavón
  • , Nayra Cabrera González
  • , Antonio Noval
  • , Rafael Calvo Rodríguez
  • , Juan Antonio Vega Reyes
  • , María Luisa López-Grima
  • , Amparo Valero
  • , María Ángeles Juan
  • , Alfons Aguirre
  • , Silvia Mínguez Masó
  • , Lluis Enric Castillero Díaz
  • , María Isabel Alonso
  • , Francisco Ruiz
  • , José Miguel Franco
  • , Ana Belén Mecina
  • , Josep Tost
  • , Marta Berenguer
  • , Ruxandra Donea
  • , Susana Sánchez Ramón
  • , Virginia Carbajosa Rodríguez
  • , Pascual Piñera
  • , José Andrés Sánchez Nicolás
  • , Paula Lázaro Aragüés
  • , Raquel Torres Garate
  • , Esther Álvarez Rodríguez
  • , Aitor Alquézar-Arbé
  • , Miguel Alberto Rizzi
  • , Sergio Herrera
  • , Javier Jacob
  • , Alex Roset
  • , Irene Cabello
  • , Antonio Haro
  • , Fernando Richard
  • , José María Álvarez Pérez
  • , María Pilar López Diez
  • , Pablo Herrero Puente
  • , Joaquín Vázquez Álvarez
  • , Belén Prieto García
  • , María García García
  • , Marta Sánchez González
  • , Pere Llorens
  • , Inmaculada Jiménez
  • , Néstor Hernández
  • , Benjamín Brouzet
  • , Begoña Espinosa
  • , Adriana Gil-Rodrigo
  • , Tamara García
  • , María Dolores Jódar
  • , Juan Antonio Andueza
  • , Rodolfo Romero
  • , Virginia Álvarez
  • , Maite del Cerro
  • , Nerea López
  • , Silvia Odeh
  • , Marta Merlo
  • , Martín Ruíz
  • , María Teresa Lorca Serralta
  • , Luis Ernesto Calderón Jave
  • , Beatriz Amores Arriaga
  • , Beatriz Sierra Bergua
  • , Enrique Martín Mojarro
  • , Brigitte Silvana Alarcón Jiménez
  • , Lisette Travería Bécquer
  • , Guillermo Burillo
  • , Lluís Llauger García
  • , Gerard Corominas LaSalle
  • , Carmen Agüera Urbano
  • , Ana Belén García Soto
  • , Elisa Delgado Padial
  • , Ester Soy Ferrer
  • , María Adroher Múñoz
  • , José Manuel Garrido
  • , Francisco Javier Lucas-Imbernón
  • , Rut Gaya
  • , Carlos Bibiano
  • , María Mir
  • , Beatriz Rodríguez
  • , José Luis Carballo
  • , Esther Rodríguez-Adrada
  • , Belén Rodríguez Miranda
  • , Monika Vicente Martín
  • , Pere Coma Casanova
  •  & Joan Espinach Alvarós

Corresponding author

Correspondence to Òscar Miró.

Ethics declarations

Conflict of interests

The authors declare that they have no conflict of interest.

Human and animal rights statement

The EAHFE Registry protocol was approved by a central Ethics Committee at the Hospital Universitario Central de Asturias (Oviedo, Spain) with the reference numbers 49/2010, 69/2011, 166/13, 160/15 and 205/17. Due to the noninterventional design of the registry, Spanish legislation allows central Ethical Committee approval, accompanied by notification to the local Ethical Committees. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional. The present study was carried out in strict compliance with the principles of the Declaration of Helsinki.

Consent to participate

All participating patients gave informed consent to be included in the registry and to be contacted for follow up.

Consent for publication

All authors had full access to the data, reviewed the final version of the paper, and gave the consent to publish the paper in the current form.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 27 KB)

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gil-Rodrigo, A., Verdú-Rotellar, J.M., Gil, V. et al. Evaluation of the HEFESTOS scale to predict outcomes in emergency department acute heart failure patients. Intern Emerg Med 17, 2129–2140 (2022). https://doi.org/10.1007/s11739-022-03068-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11739-022-03068-9

Keywords

Search

Navigation