Diagnostic accuracy of the Brest score for prediction of acute heart failure in the emergency department

Abstract

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.