Ottawa Heart Failure Risk Scale (OHFRS)
Ottawa Heart Failure Risk Scale (Stiell 2013): ten weighted history, exam, and lab items give a 0–15 score for ED heart-failure patients.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- History of stroke or TIA
- No
- Prior intubation for respiratory distress
- No
- Heart rate ≥ 110 on ED arrival
- Yes
- SaO₂ < 90% on arrival
- No
- Heart rate ≥ 110 on 3-minute walk / too ill to walk
- Yes
- New ischemic changes on ECG
- Yes
- Serum urea ≥ 12 mmol/L
- No
- Serum CO₂ ≥ 35 mmol/L
- No
- Troponin elevated to MI level
- No
- NT-proBNP ≥ 5000 ng/L
- Yes
Result: Ottawa Heart Failure Risk Scale 6 — higher risk (>= 2): at or above the recommended admission threshold.
The tool opens with these values already filled in. Replace them with your own.
What the result means
- 0
- Lowest measured risk: ~2.8% serious adverse events at 14 days.
- 1
- Above the > 1 admission threshold by one point — use clinical judgment.
- >= 2
- At or above the recommended admission threshold; serious-adverse-event risk rises to ~89% at the high end. A risk scale, not an admission order.
What you enter
- History of stroke or TIA (+1)
- Prior intubation for respiratory distress (+2)
- Heart rate ≥ 110 on ED arrival (+2)
- SaO₂ < 90% on arrival (+1)
- Heart rate ≥ 110 on 3-minute walk / too ill to walk (+1)
- New ischemic changes on ECG (+2)
- Serum urea ≥ 12 mmol/L (+1)
- Serum CO₂ ≥ 35 mmol/L (+2)
- Troponin elevated to MI level (+2)
- NT-proBNP ≥ 5000 ng/L (+1)
How this is calculated
Stiell IG, Clement CM, Brison RJ, et al. A risk scoring system to identify emergency department patients with heart failure at high risk for serious adverse events. Acad Emerg Med. 2013;20(1):17-26. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.