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EUROMACS Right Ventricular Failure (RHF) Risk Score Calculator

  • Right Atrial Pressure (RAP) — input in mmHg
  • Pulmonary Capillary Wedge Pressure (PCWP) — input in mmHg
  • Hemoglobin (Hb) — input in g/dL
  • Number of Intravenous Inotropes (pre-op) — enter an integer (0, 1, 2, 3...)
  • INTERMACS Class — enter 1 to 7 (1 = critical cardiogenic shock)
  • Severe Right Ventricular Dysfunction (Echocardiography)?
  • Optional — Cardiopulmonary Bypass (CPB) Time (minutes)
  • EUROMACS Right-Sided Heart Failure (RHF) Risk Score: Explanation and Clinical Context
     The EUROMACS-RHF score is a validated preoperative model derived from the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) to predict early (≤30 days) severe right heart failure after continuous-flow LVAD implantation.
    It uses five key preoperative variables: RAP/PCWP ratio > 0.54, hemoglobin ≤10 g/dL, ≥3 intravenous inotropes, INTERMACS class 1–3, and severe right ventricular dysfunction on echocardiography. Each factor contributes weighted points toward total score.
    Higher total scores correlate with increased RHF risk: Low (0–2 points ≈11%), Intermediate (>2–4 ≈25–28%), and High (>4 ≈40–43%) risk groups.
    Clinically, the score assists in preoperative counseling, optimization, and identifying patients at risk for postoperative RV support or adverse outcomes. External validations have shown moderate discrimination (C-statistic ~0.67–0.70), emphasizing the need for integration with full clinical assessment.

    References:
    Soliman OII, et al. Circulation. 2018; Derivation and Validation of the EUROMACS Right-Sided Heart Failure Risk Score.
    Shah H, et al. Scientific Reports. 2021; External Validation of the EUROMACS-RHF Score.

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