Are scores useful in advanced heart failure?
Advanced heart failure (HF) is becoming an increasingly challenging problem as more patients with this disease are living longer, yet experiencing its inexorable progression. Adding to this complex matter, there are different views on how to define advanced HF, whereby an acute decompensation episode does not necessarily indicate advanced disease. Several scores have been described aiming at a better prognostic performance across the HF spectrum. These include the Heart Failure Survival Score, the Seattle Heart Failure Model, the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure predictive schemes, the Acute Decompensated Heart Failure National Registry regression tree discrimination, among others. Most scoring systems have been built based on outpatient populations or recently hospitalized HF subjects. The setting of advanced HF has not gained much attention as far as prognostication is concerned, and yet there lies potentially challenging decision-making situations where issues, such as heart transplantation, use of costly devices and end-of-life questions, are raised.
Goldraich
Livia
L
Heart Failure and Cardiac Transplantation Unit, Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul Medical School, Porto Alegre, Brazil.
Beck-da-Silva
Luis
L
Clausell
Nadine
N
D002986:Clinical Trials as Topic; D006333:Heart Failure / Q000175:diagnosis*; D006801:Humans; D008954:Models, Biological; D011379:Prognosis; D012044:Regression Analysis; D018570:Risk Assessment / Q000379:methods; D012720:Severity of Illness Index