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HF-CARB (Chronic Ambulatory HF Risk Model) Calculator

  • NYHA class III-IV?
  • Clinical signs of congestion (present)?
  • Hospital admission for HF or ED visit for decompensation in the previous 12 months?
  • Daily loop diuretic dose ≥ 40 mg furosemide (or equivalent)?
  • NT-proBNP ≥ 1,000 pg/mL (if available)?
  • HF-CARB (Chronic Ambulatory Heart Failure Risk Model) — explanation and clinical context
    This 5-item clinical model (derived from IC-BERG recommendations) evaluates ambulatory patients with chronic heart failure at the clinic by checking five simple features: NYHA class III–IV, clinical signs of congestion, a hospitalization or emergency visit for HF in the previous 12 months, a daily loop diuretic dose ≥40 mg furosemide (or equivalent), and an elevated natriuretic peptide (NT-proBNP ≥1,000 pg/mL). Each item counts 1 point; the total score ranges 0–5. In the original cohort (n=1,909), an increasing number of items was associated with progressively higher adjusted hazard ratios for the combined endpoint of death or HF admission (HR 1.47 for 1 item, 2.03 for 2 items, 2.98 for 3 items, 5.07 for 4 items and 7.73 for 5 items, each compared to 0 items). This makes the score a fast bedside tool to flag patients who may need closer follow-up, therapy optimization, or advanced care planning. For absolute event probability at a fixed timepoint, consult the original Kaplan-Meier curves or cohort baseline hazard because absolute risks depend on baseline incidence in the derivation cohort.

    Reference:
    Barge-Caballero E, Barge-Caballero G, Paniagua-Martín MJ, et al. Prognostic value of a model based on IC-BERG recommendations in ambulatory patients with heart failure. REC: CardioClinics. 2022;57:76–84. DOI:10.1016/j.rccl.2021.06.004.

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