Killip Classification for Heart Failure

Why Use

Predicts mortality in ACS and is validated for both STEMI and NSTEMI.

When to Use

Patients with confirmed acute coronary syndrome.

Formula

Pearls / Pitfalls

Developed in the 1960s, before reperfusion therapy (thrombolytics, PCI); however, has been shown across several studies since then to still be predictive of mortality. Mortality rates have declined significantly since the original study. Can be used in both STEMI and NSTEMI.

Advice

Can be used as part of the full clinical picture to help decide among treatment options, including reperfusion therapy and intra-aortic balloon pump placement.

More Information

Interpretation: Class 30-day mortality* In-hospital mortality** (historical interest only) I 2-3% <6% II 5-12% <17% III 10-20% 38% IV 81% *From Khot 2003 , which combined class III/IV owing to relatively smaller number of patients in class IV (0.3% of patients). **From Killip 1967 .