Key result
Risk stratification in acute heart failure is critical for evaluating long-term prognosis and guiding management decisions, though further research is needed to evaluate its impact on outcomes.
Risk stratification in acute heart failure is critical for evaluating prognosis, guiding care level decisions, and identifying patients for advanced therapies or early follow-up.
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May support risk-stratified post-discharge plans in acute HF; hypothesis-generating and requires prospective validation before practice change.
Acute Heart Failure (AHF) is a " multi-event disease" and hospitalisation is a critical event in the clinical course of HF. Despite relatively rapid relief of symptoms, hospitalisation for AHF is followed by an increased risk of death and re-hospitalisation. In AHF, risk stratification from clinically available data is increasingly important in evaluating long-term prognosis. From the perspective of patients, information on the risk of mortality and re-hospitalisation would be helpful in providing patients with insight into their disease. From the perspective of care providers, it may facilitate management decisions, such as who needs to be admitted and to what level of care (i.e. floor, step-down, ICU). Furthermore, risk-stratification may help identify patients who need to be evaluated for advanced HF therapies (i.e. left-ventricle assistance device or transplant or palliative care), and patients who need early a post-discharge follow-up plan. Finally, risk stratification will allow for more robust efforts to identify among risk markers the true targets for therapies that may direct treatment strategies to selected high-risk patients. Further clinical research will be needed to evaluate if appropriate risk stratification of patients could improve clinical outcome and resources allocation.
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Chioncel et al. (2017) conducted a review in Acute Heart Failure. Risk stratification in acute heart failure is critical for evaluating long-term prognosis and guiding management decisions, though further research is needed to evaluate its impact on outcomes.
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