Prognosis of heart failure in the elderly: not an affair of the heart?

During the past several years, prognostic instruments have been developed for patients with heart failure (HF), predicting a number of clinical outcomes, including mortality and rehospitalization.1–3 Few similar instruments for shortterm prognosis have appeared designed specifically for use in the elderly with HF. Pilotto et al4 have addressed this gap by creating a prognostic instrument that places new emphasis on a whole array of geriatric tools. The Multidimensional Prognostic Index (MPI) is derived from a comprehensive geriatric assessment (CGA). This new tool demonstrates powerful predictive capabilities for 30-day mortality in elderly patients, especially for men, hospitalized for HF, in comparison with more traditional prognostic tools such as the New York Heart Association class, or indices derived from ADHERE2 or the EFFECT measure.3