Cardiac failure has a very poor long term outcome and the prognosis can be worse than that of many cancers.

The ESC 2016 Guidelines report that acute heart failure associated with cardiogenic shock has a poor prognosis. However, in those that present with hypertensive acute heart failure, the in-hospital mortality is low [1].

In the 3CPO trial, the 7-day mortality was 9.5% for the NIV arms, 9.8% for the standard therapy arm and 9.9% for non-recruited patients.  The 30-day mortality was 15.2% in the combined NIV arms and 16.2% in the standard therapy arm [4].

A worse outcome is associated with [1]:

  • Advanced Age
  • Wide QRS
  • Hyponatraemia
  • Low Left Ventricular Ejection Fraction
  • Hypotension
  • Precipitated by ischaemia
  • Previous hospitalisation for heart failure
  • Marked BNP elevation
  • Elevated troponin
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