Prognostic value of palliative care needs in patients with heart failure: Insights from the Integrated Palliative Care Outcome Scale

Introduction Heart failure (HF) is a leading cause of morbidity and mortality, often accompanied by significant symptom burden. Palliative care remains underutilized in HF management. Identifying palliative care needs (PCN) early may improve outcomes. The prognostic value of the Integrated Palliative Care Outcome Scale (IPOS) in HF remains unclear. This study explores the relationship between PCN and clinical outcomes. Aims To explore the prognostic implications of palliative care needs (PCN) in hospitalized patients with heart failure (HF) and to assess the relationship between PCN severity and patient characteristics. Methods A single-center, prospective cohort study was conducted on 160 patients admitted with heart failure. Patients completed the Integrated Palliative Care Outcome Scale (IPOS) questionnaire within the first two days of admission. PCN was defined as having ≥2 items with a score of 4 or ≥3 items with a score ≥3. Mortality data were collected through follow-up. Multivariable analysis was performed to determine independent predictors of mortality. Results The prevalence of PCN was 59.38%. The most common symptoms were shortness of breath (57.50%), weakness (51.88%), and pain (45.63%). Patients with PCN had longer disease duration, lower eGFR, and were more likely to receive intravenous medication. After adjusting for age and MAGGIC score, PCN remained an independent predictor of mortality (HR: 2.63, 95% CI: 1.06-6.53, p=0.037). Notably, HF severity indicators (NYHA class, LVEF, NT-proBNP) did not predict PCN. Conclusion PCN is prevalent in HF patients and serves as an independent predictor of mortality. Routine PCN assessment may enhance risk stratification and guide early palliative care interventions.