The New York University Pediatric Heart Failure Index: A new method of quantifying chronic heart failure severity in children

Abstract

Objective: The assessment of the severity of heart failure in pediatric patients is handicapped by the subjectivity of diagnostic parameters. This study evaluated the feasibility of a new standardized heart failure index, the New York University Pediatric Heart Failure Index (NYU PHFI), to quantify the degree of heart failure in a selected pediatric population. Methods and Results: The index is a weighted, linear combination of scores based on symptoms, physical signs, and medical regimen. Overall, healthy children (n = 12) scored very low (0 to 2) on this index. Mean scores of children (<2 years; mean age, 4.8 months; n = 12) with a left-toright shunt lesion declined from 11.4 (SD ± 4.1, P < .001, 2-tailed test) before surgery to 1.8 (SD ± 1.3) after surgical correction of their cardiac defects. The average inter-observer correlation coefficient was 0.95 (P < .001), despite a wide range of scores. Conclusions: The NYU PHFI appears to be a reliable and convenient instrument for measuring heart failure severity in children. These initial results support further testing in broader diagnostic and age groups and over longer periods.