Pulmonary edema prognostic score predicts in-hospital mortality risk in patients with acute cardiogenic pulmonary edema

Heart Lung. 2008 Jan-Feb;37(1):46-53. doi: 10.1016/j.hrtlng.2007.05.005.


Background: Congestive heart failure is a common cardiac disorder associated with a high mortality. There are a limited number of prognostic scales predicting in-hospital outcomes after an acute episode of congestive heart failure.

Objectives: The goal of this investigation was to develop a simple prognostic score predicting in-hospital outcome in patients with acute cardiogenic pulmonary edema.

Methods: We retrospectively studied 276 consecutive patients hospitalized with acute pulmonary edema from the years 1998 to 2000.

Results: During the initial hospitalization, 58 patients (21%) died and 218 patients (79%) were discharged. Statistical analyses revealed that the most significant predictors of inhospital mortality were acute myocardial infarction, heart rate greater than 115/beats/min, systolic blood pressure of 130 mm Hg or less, and white blood cell count greater than 11,500/mm3 on presentation. The presence of each factor was scored as 1 point, and the absence was scored as 0 points. The Pulmonary Edema Prognostic Score (PEPS) was defined as a sum of all points. Patients with a PEPS of 0 had good short-term prognosis with a 2% in-hospital mortality rate, whereas mortality in patients with a PEPS of 4 was 64%.

Conclusions: The PEPS is a simple tool that can be easily calculated using common clinical diagnostic tests (electrocardiogram, blood pressure, heart rate, and white cell count) to determine in-hospital mortality risk in patients with an acute episode of cardiogenic pulmonary edema.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Diastole
  • Female
  • Health Status Indicators
  • Hospital Mortality*
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Pulmonary Edema / mortality*
  • Retrospective Studies
  • Risk Factors
  • Shock, Cardiogenic / etiology*
  • Shock, Cardiogenic / mortality
  • Systole
  • Ventricular Dysfunction, Left