ESCAPE Hemodynamic Congestion Index (HCI) Calculator

ESCAPE Trial Hemodynamic Congestion Index: Rationale, clinical meaning, and evidence The Hemodynamic Congestion Index (HCI) implemented here is the simple sum of right atrial pressure (RAP) and pulmonary capillary wedge pressure (PCWP): HCI = RAP (mmHg) + PCWP (mmHg). This index was derived from analyses of the ESCAPE trial dataset and related secondary analyses that examined whether a single composite invasive pressure target could summarise residual intravascular congestion and predict 6-month outcomes. In analyses using ESCAPE pulmonary-artery catheter data, a post-treatment RAP+PCWP threshold of 30 mmHg distinguished two groups with markedly different outcomes: patients with post-treatment RAP+PCWP < 30 mmHg experienced substantially lower 6-month mortality and readmission compared with those with RAP+PCWP ≥ 30 mmHg.

Thus, HCI provides a pragmatic, evidence-based single-number summary of invasive right- and left-sided filling pressures and can help identify patients who remain hemodynamically congested despite therapy and who may benefit from closer follow-up or intensified decongestive strategies.