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

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.