Emergency Heart Failure Mortality Risk Grade (EHMRG)

Risk stratify patients with acutely decompensated heart failure

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About this Calculator

This prospective, multicenter study included 1983 acute heart failure patients who presented to the emergency department.

The Emergency Heart failure Mortality Risk Grade (EHMRG7) was used to determine the risk of 7-day and 30-day mortality and outperformed physicians’ estimate of risk.

Seven-day mortality rates were 0%, 0%, 0.6%, 1.9%, and 3.9% in those at very low, low, intermediate, high, and very high risk.

Of particular note, physicians over-estimated risk in low risk patients, and underestimated risk in the highest-risk group. This may explain prior data that shows that clinical judgement of risk may result in low-risk patients being hospitalized, or higher risk patients being discharged home.

The EHMRG model serves to provide risk estimates that complements clinical judgment in the decision to admit or perform early discharge of patients from the hospital or the emergency department.


Lee DS, Lee JS, Schull MJ, Borgundvaag B, Edmonds ML, Ivankovic M, McLeod SL, Dreyer JF, Sabbah S, Levy PD, O'Neill T, Chong A, Stukel TA, Austin PC, Tu JV.

Prospective Validation of the Emergency Heart Failure Mortality Risk Grade for Acute Heart Failure.

Circulation 2018 November 29

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