Prediction of Heart Failure Mortality in Emergent Care A Cohort Study

Background: Heart failure contributes to millions of emergency department (ED) visits, but hospitalization-versus-discharge deci-sions are often not accompanied by prognostic risk quantification. Objective: To derive and validate a model for acute heart failure mortality applicable in the ED. Design: Clinical data abstraction with development of a broadly applicable multivariate risk index for 7-day death using initial vital signs, clinical and presentation features, and readily available labo-ratory tests. Setting: Multicenter study of 86 hospitals in Ontario, Canada. Patients: Population-based random sample of 12 591 patients pre-senting to the ED from 2004 to 2007. Measurements: Death within 7 days of presentation. Results: In the derivation cohort (n 7433; mean age, 75.4 years [SD, 11.4]; 51.5 % men), mortality risk increased with higher triag