National Heart Failure Registry (NHFR-JO) – Data Entry Form (Core Fields)
National Heart Failure Registry (NHFR-JO) – Data Entry Form (Core Fields)
1. Patient Identification
• Registry ID
• Hospital / Center Name
• Admission Number
• Date of Admission / Date of Discharge
2. Demographics
• Age (years)
• Sex (M / F)
• Nationality / Residency
• Smoking Status (Current / Former / Never)
• Weight in Kg / Body Mass Index (BMI)
3. Clinical Classification
• Heart-Failure Type: Chronic / Acute-on-Chronic / De Novo(De Novo HF: first-time heart-failure presentation (≈ 11 % in JoHFR), most often precipitated by acute myocardial infarction (MI) or myocarditis.)
• LVEF (%) → HFrEF (≤ 40 %) / HFmrEF (41–49 %) / HFpEF (≥ 50 %)
• Etiology: Ischemic / Hypertensive / Valvular / Dilated / Other
4. Comorbidities (Checkbox)
Hypertension / Diabetes / Coronary Artery Disease / CKD / COPD / Stroke / AF / Obesity / Anemia / Other
5. Presentation & Vitals
• Dyspnea (Y/N) Orthopnea (Y/N) PND (Y/N) Chest Pain (Y/N)
• SBP / DBP HR O₂ Sat % NYHA Class (I–IV)
6. Key Labs (First 24 h)
• BNP / NT-proBNP
• Creatinine mg/dL eGFR mL/min/1.73 m²
• Sodium mmol/L Potassium mmol/L
• Hemoglobin g/dL Ferritin ng/mL
7. Echocardiography
• LVEF % LVEDD mm E/e′ MR grade PASP mmHg
8. Medications (Guideline-Directed Medical Therapy – GDMT)
• ACEI / ARB / ARNI
• Prescribed: Yes / No
• Action: Start / Continue / Contraindicated
• Notes: specify reason if not prescribed (renal function, hypotension, cost, etc.)
• Beta-Blocker
• Prescribed: Yes / No
• Action: Start / Continue / Hold if low BP or bradycardia
• Notes: indicate specific agent if available (e.g., bisoprolol, carvedilol, metoprolol succinate)
• Mineralocorticoid Receptor Antagonist (MRA)
• Prescribed: Yes / No
• Action: Start / Continue / Contraindicated
• Notes: specify serum K⁺ and eGFR for eligibility
• SGLT2 Inhibitor
• Prescribed: Yes / No
• Action: Start / Continue / Not Available / Cost Barrier
• Notes: applicable for both HFrEF and HFpEF categories
• Loop Diuretic
• Prescribed: Yes / No
• Form: IV / Oral / Not Used
• Notes: record dose and frequency (e.g., furosemide 40 mg BID)
Additional Notes:
• Indicate dose and titration status where applicable.
• Document contraindication reasons explicitly (renal dysfunction, hyperkalemia, hypotension, allergy, etc.).
• Use standardized drug codes (RxNorm or equivalent) for digital registry entry.
• These variables represent the four pillars of GDMT aligned with ESC EORP HF-III and AHA GWTG-HF datasets.
9. Device Therapy
• ICD (Y/N) CRT (Y/N) If No → Reason (Cost / Access / Not Eligible)
10. Discharge Plan
• Medications reconciled (Y/N)
• Education provided (Y/N)
• Follow-up ≤ 14 days (Y/N)
• Referral to HF Clinic (Y/N)
11. Outcomes(Each recorded as a separate field — enabling standardized national reporting. )
• In-hospital mortality (Y/N)
• Length of stay (days)
• 30-day readmission (Y/N)
• 1-year mortality (Y/N)
1-year mortality (Yes/No): recorded at 12-month follow-up to indicate patient survival status after hospital discharge.
Notes for Use
• All numeric entries auto-validated against reference ranges.
• Mandatory fields highlighted in color.
• Information came from updates and communications with AHA / ESC
The registry is designed to connect automatically with hospital systems using global data standards (HL7/FHIR) and follows key definitions from ESC and AHA registries to keep information accurate, compatible, and internationally aligned.
