The Emergency Heart Failure Mortality Risk Grade (EHMRG) Score
Understanding the Tool
The Emergency Heart Failure Mortality Risk Grade (EHMRG) Score was developed to help emergency physicians accurately identify patients with acute heart failure who are at low risk for 7-day mortality and are safe candidates for early discharge or outpatient management.
The EHMRG Score uses 10 clinical variables readily available at the time of emergency department assessment, allowing rapid, evidence-based triage decisions that reduce unnecessary hospital admissions.
- 10 readily available clinical variables
- Validated in large multi-centre cohorts
- Reduces unnecessary hospitalizations
- Supports safer early discharge decisions
Program Capabilities
Watch how the EHMRG Score is applied in a real emergency department setting to optimize patient disposition and reduce unnecessary admissions.
Launch the EHMRG Calculator
Tool Success by the Numbers
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Emergency patients assessed
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Peer-reviewed validation studies
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Countries of implementation
The EHMRG Score Evidence
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The EHMRG Score was initially derived from a prospective cohort of over 1,000 patients across multiple academic emergency departments, demonstrating an area under the ROC curve of 0.88 for 7-day mortality prediction.
- Multi-centre prospective derivation cohort
- Validated in independent external cohorts
- Robust performance across demographic subgroups
- Consistent results in both academic and community hospitals
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Implementation of the EHMRG Score in emergency departments has demonstrated meaningful reductions in unnecessary hospital admissions while maintaining patient safety, with no increase in 7-day adverse outcomes.
- Significant reduction in hospitalization rates for low-risk patients
- No increase in 7-day mortality or serious adverse events
- Improved emergency department throughput
- Enhanced physician confidence in disposition decisions
Toolkit
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Case Study
Explore a real-world implementation of the EHMRG Score across a regional emergency department network, demonstrating how the tool reduced hospitalizations while maintaining patient safety outcomes.
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Implementation Checklist
A step-by-step guide for emergency department teams looking to integrate the EHMRG Score into standard clinical workflows, including staff training, documentation requirements, and quality monitoring.
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EHMRG Score Infographic
A visual summary of the EHMRG Score variables, scoring methodology, and risk thresholds for clinical decision making in the emergency department.
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Acute Heart Failure Risk Stratification and Disposition
A comprehensive reference guide for clinicians on applying risk stratification frameworks for acute heart failure patients presenting to the emergency department.
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Educational Rounds
Access presentation materials, teaching cases, and educational resources for training emergency medicine residents and staff on EHMRG Score application.
News and Publications
Showing 8 out of 10 results
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Canadian Cardiovascular Society/Canadian Pediatric Cardiology Association Focused Guidelines on Acute Heart Failure in Children.
2026 | The Canadian journal of cardiology
Aamir Jeewa, Ivan D. Florez, Carlos Cuello-Garcia, Nassiba Alami, Luis Altamirano-Diaz, Kathryn Armstrong, Jenna Ashkanase, Chentel Cunningham, Santokh Dhillon, Anne Dipchand, Linda Fazari, Lars Grosse-Wortmann, Paula Holinski, Michael Khoury, Kimberly Y. Lin, Joseph Rossano, Simon Urschel, Laura Zahavich, Paul F. Kantor, Jennifer Conway, Joseph Atallah, Holger Bucholz, Catherine Chant-Gambacourt, Frédéric Dallaire, Adrian Dancea, Anne Fournier, Kristen George, Steven Greenway, Derek G. Human, Jane Lougheed, Allison Mejilla, Jack F. Price, S. Lucy Roche, Lindsay Ryerson
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Clinical Images: Biopsy-proven hydroxychloroquine-induced cardiomyopathy in an adolescent with systemic lupus erythematosus.
2026 | Arthritis & rheumatology (Hoboken, N.J.)
Mastrangelo G, Levy DM, Nagy A, Jeewa A.
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Limitations of ventricular assist devices in pediatrics: When one size does not fit all.
2026 | JHLT open
Lynch Á, Jeewa A.
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Modifiable Health Behaviours in Children with HCM: Lessons from the Heart Health Survey.
2026 | Pediatric cardiology
Wagner MJ, Jeewa A, Pidborochynski T, Lemaire-Paquette S, Khoury M, Cunningham C, Dhillon S, Laroussi NA, Vaujois L, Dallaire F, Schantz D, Armstrong K, Mawad W, Bradley TJ, Conway J
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From sudden stroke to heart transplant: unmasking restrictive cardiomyopathy in an adolescent: a case report.
2026 | European heart journal. Case reports
López-Guillén JL, Seed M, Dipchand AI, Jeewa A, Griesman J.
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Revaccination of individuals with cardiac adverse events following COVID-19 vaccination: A Canadian Immunization Research Network study.
2026 | Vaccine
Piché-Renaud PP, Buchan CA, Burton C, Chapdelaine H, Jeewa A, Morris SK, Pernica JM, Pham-Huy A, Sadarangani M, Salvadori MI, Suresh S, Kafil TS, Cowan J, Top KA, Special Immunization Clinic Network investigators.
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Explantation of durable ventricular assist device for myocardial functional recovery in children: A report from the ACTION registry.
2026 | The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
Bhavikkumar Langanecha, Aamir Jeewa, Iki Adachi, Constantine D. Mavroudis, Muhammad Shezad, Mohammed Absi, Othman Aljohani, Shahnawaz Amdani, Scott Auerbach, Ryan Butts, Jonathan Byrnes, Chesney Castleberry, Jennifer Conway, Jonathan B. Edelson, Anna Joong, Sairah Khan, Steven Kindel, Sabrina Law, Angela Lorts, Lindsay May, Deipanjan Nandi, John Jerry Parent, Joseph Philip, David Rosenthal, David Sutcliffe, Hari Tunuguntla, Christina VanderPluym, Matthew Zinn, Matthew J. O’Connor, Kyle Hope
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A Pediatric Case of Hydroxychloroquine Cardiotoxicity Leading to End-stage Heart Failure.
2025 | The Canadian journal of cardiology
Raj Lalli, Alyssa Power, Deborah M. Levy, Anita Nagy, Christoph Haller, Leonardo R. Brandão, Oshri Zaulan, Bhavikkumar Langanecha, Andrea Maurich, Aamir Jeewa