adhere_algorithm: ADHERE Algorithm for Acute Decompensated Heart Failure

In cliot: Clinical Indices and Outcomes Tools

ADHERE Algorithm for Acute Decompensated Heart Failure

Description

Implements the classification regression tree (CART) analysis from the Acute Decompensated Heart Failure National Registry (ADHERE). This algorithm uses admission Blood Urea Nitrogen (BUN), Systolic Blood Pressure (SBP), and Serum Creatinine to stratify patients into four risk groups for in-hospital mortality.

Usage

adhere_algorithm(bun, sbp, creatinine)

Arguments

bun	Numeric. Blood Urea Nitrogen in mg/dL. (The first splitting node is at 43 mg/dL).
sbp	Numeric. Systolic Blood Pressure in mmHg. (The second splitting node is at 115 mmHg).
creatinine	Numeric. Serum Creatinine in mg/dL. (The third splitting node is at 2.75 mg/dL).

Value

A list containing:

Risk_Group	The risk classification (Low, Intermediate, High, or Very High).
In_Hospital_Mortality_Risk	The estimated in-hospital mortality percentage associated with the specific node in the validation set.

References

Fonarow GC, Adams KF Jr, Abraham WT, et al. Risk stratification for in-hospital mortality in acutely decompensated heart failure: classification and regression tree analysis. JAMA. 2005;293(5):572-580. doi:10.1001/jama.293.5.572

Examples

# Example 1: Low Risk (BUN < 43)
adhere_algorithm(bun = 30, sbp = 120, creatinine = 1.0)

# Example 2: Very High Risk (BUN >= 43, SBP < 115, Cr >= 2.75)
adhere_algorithm(bun = 50, sbp = 100, creatinine = 3.0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.