EUROMACS Right Ventricular Failure (RHF) Risk Score Calculator

EUROMACS Right-Sided Heart Failure (RHF) Risk Score: Explanation and Clinical Context The EUROMACS-RHF score is a validated preoperative model derived from the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) to predict early (≤30 days) severe right heart failure after continuous-flow LVAD implantation. It uses five key preoperative variables: RAP/PCWP ratio > 0.54, hemoglobin ≤10 g/dL, ≥3 intravenous inotropes, INTERMACS class 1–3, and severe right ventricular dysfunction on echocardiography. Each factor contributes weighted points toward total score.

Higher total scores correlate with increased RHF risk: Low (0–2 points ≈11%), Intermediate (>2–4 ≈25–28%), and High (>4 ≈40–43%) risk groups. Clinically, the score assists in preoperative counseling, optimization, and identifying patients at risk for postoperative RV support or adverse outcomes. External validations have shown moderate discrimination (C-statistic ~0.67–0.70), emphasizing the need for integration with full clinical assessment.