Key result
Brest score predicts acute heart failure in ED dyspnea patients with an AUC of 0.84.
Why the study?
Early diagnosis of acute heart failure is challenging in the emergency department, where diagnosis relies mainly on clinical signs and standard parameters, and the Brest score could improve diagnostic accuracy and speed.
Does the Brest score accurately predict acute heart failure in adult patients presenting with acute dyspnea in the emergency department?
Observational (n=100)
No
Does the Brest score accurately predict acute heart failure in adult patients presenting with acute dyspnea in the emergency department?
Effect estimate: AUC 0.84 (95% CI 0.667-1)
p-value: p=<0.001
The Brest score is a reliable, rapid, and noninvasive bedside tool with high accuracy for identifying acute heart failure in patients presenting with undifferentiated dyspnea in the emergency department.
May support Brest score for rapid AHF prediction in ED dyspnea; leaves open prospective validation before practice change.
Background Early diagnosis and appropriate management of acute heart failure (AHF) is aimed at better hemodynamic balance, improved functional capacity, decreased mortality, and shorter length of hospital stay. However, this is often a challenge in the emergency department (ED), where diagnosis is mainly based on clinical signs and standard parameters. Early use of Brest score could reduce the diagnosis time and improve diagnostic accuracy. Purpose The aim of this study is to evaluate the validity of the Brest score in the prediction of AHF in undifferentiated dyspnea in ED. Patients and methods The study was conducted on 100 adult patients admitted to the ED of Alexandria Main University Hospital with acute dyspnea. The study was conducted to reach initial impression about AHF diagnosis, which was then compared with the final diagnosis to determine accuracy, agreement, sensitivity, and specificity. Results The data acquired from Brest score in the diagnosis of HF is compared with echocardiography as a gold standard. The area under the receiver-operating characteristic curve for the data received from Brest score was 0.84, 95% confidence interval: 0.667–1, with a P value lower than 0.001 being highly significant. Conclusion The Brest score showed high accuracy in identifying AHF in ED, so it is considered a bedside, reliable, rapid, and noninvasive technique.
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Fatah et al. (2023) conducted an observational in Acute heart failure (n=100). Brest score vs. Echocardiography was evaluated on Prediction of acute heart failure (AUC 0.84, 95% CI 0.667-1, p=<0.001). The Brest score demonstrated high accuracy for predicting acute heart failure in emergency department patients with acute dyspnea (AUC 0.84; 95% CI 0.667-1; P<0.001).
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