Multivariate risk scores provide a more accurate understanding of prognosis in advanced heart failure compared to unstructured clinical assessment, aiding in complex therapeutic decision-making.
Significant improvements in survival have occurred for patients with advanced heart failure, with an increasing array of therapeutic options sharing quite varied properties of cost, invasiveness, and impact on life expectancy. Risk models allow patients and providers to achieve a better understanding of prognosis than is possible through unstructured holistic assessment. This article reviews scoring systems for heart failure prognostication in the general sense and in the setting of providing answers to specific clinical queries. Topics addressed include outpatient survival, risk of inpatient and post-discharge mortality, potential changes to clinician decision-making through better understanding of prognosis, and mortality after having a left ventricular assist device placed or receiving an implantable cardiac-defibrillator.
Ketchum et al. (2011) studied this question.