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Prognostication and disease trajectory 

Prognostication and disease trajectory
Chapter:
Prognostication and disease trajectory
Author(s):

Miriam Johnson

, Karen Hogg

, James Beattie

, and Max Watson

DOI:
10.1093/med/9780199299300.003.0026
Page of

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date: 22 October 2019

The poor prognosis of patients with heart failure is well known and this persists despite the advanced therapeutic heart failure strategies that now exist. Prognostication remains complex aspect of heart failure management. Many factors contribute to this complexity but the unpredictable illness trajectory associated with heart failure especially compared with the illness trajectory associated with cancer is a major issue. The effect is often “prognostic paralysis”. This chapter discusses these issues and also the relevance of prognostic scoring systems in the assessment of the palliative needs of patients with advanced heart failure. This chapter also reviews a prognostic approach compared to a problem-based approach in the management of this patient group.

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