Key result
Higher EHMRG30-ST mortality risk correlates with higher care costs up to one year post-ED.
Why the study?
Although EHMRG30-ST predicts 30-day mortality in heart failure patients presenting to the emergency department, its relationship with costs of care remains unclear.
Does the EHMRG30-ST score correlate with costs of care in heart failure patients presenting to the emergency department?
Cohort (n=11,407)
Does the EHMRG30-ST score correlate with costs of care in heart failure patients presenting to the emergency department?
p-value: p=<0.0001
The EHMRG30-ST mortality risk score for heart failure patients in the emergency department positively correlates with healthcare costs up to 1 year, suggesting its utility in resource planning.
May inform ED resource planning by EHMRG30-ST risk; leaves open prospective validation of score-guided strategies.
Background: The Emergency Heart Failure Mortality Risk Grade (EHMRG30-ST) is a clinically validated model that predicts 30-day mortality in heart failure patients presenting to the emergency department (ED). However, the relationship between the EHMRG30-ST score and costs of care remains unclear. In this study, we explored the relationship between the EHMRG30-ST score and costs of care at 90 and 365 days after the index ED visit, and identified predictors of costs at 90 days. Methods: We combined 2 chart review databases, including 11,407 patients presenting to the ED with heart failure between 2004-2007. We estimated the costs from administrative databases. We stratified patients into quintiles (Q) of EHMRG30-ST scores (Q1 = lowest risk; Q5 = highest risk), and compared the total costs in 2021 Canadian dollars at 90 and 365 days by score quintiles. We further examined the cost breakdown by categories. Finally, we used a generalized linear model to identify predictors of 90-day costs. A positive correlation between EHMRG30-ST risk quintile and cost was observed for subcategories of hospital costs, long-term-care, and home care. Major predictors of 90-day costs were ejection fraction measurement and troponin levels. Conclusions: Higher mortality risk as determined by the EHMRG30-ST score was associated with higher costs for up to 1 year after the initial ED presentation. Our study suggests that costs of care may be another potential dimension of the utility of prognostic risk scores.
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Abdul-Samad et al. (2025) conducted a cohort in Heart failure (n=11,407). Emergency Heart Failure Mortality Risk Grade (EHMRG30-ST) score vs. Lower risk quintiles was evaluated on Costs of care at 90 and 365 days (p=<0.0001). Higher mortality risk determined by the EHMRG30-ST score was positively correlated with higher costs of care up to 1 year after initial ED presentation (P<0.0001).
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