end of life, heart failure, palliative care, prognosis



  1. James, Toni MSN, RN, CNL, CHPN
  2. Offer, Melinda MSN, RN
  3. Wilson, Marian MPH, RN, CHPN
  4. Delyea, Audra BSN, RN
  5. Johnson, Dawn RN, BS


Heart failure is a common hospital admission diagnosis and a progressive terminal disease. Prognosis is difficult to predict, and patients are often unaware of their poor prognosis. The Seattle Heart Failure Model is a tool that predicts life expectancy for heart failure patients. The aim of this study was to determine if this tool could identify heart failure inpatients who would benefit from palliative care referrals. The tool was applied retrospectively to 214 patients with a discharge diagnosis of heart failure. Cases were divided for data analysis into three groups of predicted baseline life expectancy: those with prognosis of less than or equal to 1.5 years, more than 1.5 years to less than 5 years, and 5 years or more. Of those with life expectancy equal to or less than 1.5 years, 63% of these patients (n = 17) would have received timely palliative care consultation had the Seattle Heart Failure Model been used as a screening tool. More research is needed to explore the use of this tool and others for inpatients with heart failure. Such tools can be helpful in ensuring that patients receive the information they need to make end-of-life decisions.