ArticleFrontiers in cardiovascular medicine2022
Enhancing Palliative Care for Patients With Advanced Heart Failure Through Simple Prognostication Tools: A Comparison of the Surprise Question, the Number of Previous Heart Failure Hospitalizations, and the Seattle Heart Failure Model for Predicting 1-Year Survival.
Article in Frontiers in cardiovascular medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Factors associated with a positive response to the surprise question in complex chronic patients treated by advanced practice nurses in primary care.BMC palliative care · 2026Article
- Palliative Care Needs Assessment Using the Surprise Question in Hospitalized Patients With Heart Failure.Journal of the American Heart Association · 2025Observational
- National strategy for integrating palliative care into standard cardiac care for people living with heart failure: a position statement from the joint working group of the Swiss Societies of Cardiology and Palliative Care.Frontiers in cardiovascular medicine · 2025Article
- An retrospective study on the effects of deep learning model-based optimization emergency nursing on treatment compliance and curative effect of patients with acute left heart failure.BMC emergency medicine · 2024Article
- The Surprise Question: Not Ready for Prime Time.Palliative medicine reports · 2024Article
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Authors and funding
5 authors.
Funding
Abstract
Background: Score-based survival prediction in patients with advanced heart failure (HF) is complicated. Easy-to-use prognostication tools could inform clinical decision-making and palliative care delivery. Objective: To compare the prognostic utility of the Seattle HF model (SHFM), the surprise question (SQ), and the number of HF hospitalizations (NoH) within the last 12 months for predicting 1-year survival in patients with advanced HF. Methods: We retrospectively analyzed data from a cluster-randomized controlled trial of advanced HF patients, predominantly with reduced ejection fraction. Primary outcome was the prognostic discrimination of SHFM, SQ ("Would you be surprised if this patient were to die within 1 year?") answered by HF cardiologists, and NoH, assessed by receiver operating characteristic (ROC) curve analysis. Optimal cut-offs were calculated using Youden's index (SHFM: <86% predicted 1-year survival; NoH ≥ 2). Results: Of 535 subjects, 82 (15.3%) had died after 1-year of follow-up. SHFM, SQ, and NoH yielded a similar area under the ROC curve [SHFM: 0.65 (0.60-0.71 95% CI); SQ: 0.58 (0.54-0.63 95% CI); NoH: 0.56 (0.50-0.62 95% CI)] and similar sensitivity [SHFM: 0.76 (0.65-0.84 95% CI); SQ: 0.84 (0.74-0.91 95% CI); NoH: 0.56 (0.45-0.67 95% CI)]. As compared to SHFM, SQ had lower specificity [SQ: 0.33 (0.28-0.37 95% CI) vs. SHFM: 0.55 (0.50-0.60 95% CI)] while NoH had similar specificity [0.56 (0.51-0.61 95% CI)]. SQ combined with NoH showed significantly higher specificity [0.68 (0.64-0.73 95% CI)]. Conclusion: SQ and NoH yielded comparable utility to SHFM for 1-year survival prediction among advanced HF patients, are easy-to-use and could inform bedside decision-making.
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