Acute Heart Failure in the Emergency Department: Respiratory Rate as a Risk Predictor.

Background/aim: Several risk scores can stratify patients with acute heart failure (AHF) at the Emergency Department (ED). Registration of vital signs, such as blood pressure (BP), heart rate (HR) and respiratory rate (RR) upon admission is mandatory. Nevertheless, measurement of RR remains neglected worldwide.
Patients and Methods: The predictive value of RR in classifying patients with AHF was investigated by processing several vital signs recorded in the ED.
Results: HR and RR individually did not discriminate patients according to hospitalization length, Intensive Care Unit (ICU) admittance, mechanical respiratory support or death. The derivative indices, HR:RR and Respiratory Efficacy Index (REFI) (=RR×100/SatO ₂ ), differentiated study patients regarding hospitalization length. Receiver operating characteristic curves predicting mortality and ICU admission for REFI and HR:RR revealed high accuracy, sensitivity and specificity for cut-off values of REFI >27 and HR:RR ≥4.
Conclusion: The RR and its derivative indices are easily accessible vital signs monitored at the ED which merit 'revitalization'.
(Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)