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Published on: June 10, 2025
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End-of-life preferences for patients admitted for heart failure. PREFICTER study
Prado Salamanca Bautista1, Carlos Alberto Pazos Amodeo2, Alberto Muela Molinero3
1Servicio de Medicina Interna, Hospital Universitario Virgen Macarena, Seville, Spain; Departamento de Medicina, Facultad de Medicina, Universidad de Sevilla, Seville, Spain.
Revista Espanola De Cardiologia (English Ed.)
|December 20, 2025
Summary
Elderly heart failure patients prioritize quality of life and symptom relief over longevity. Advance care planning for these patients should be proactive and systematic to address their end-of-life preferences.
Area of Science:
- Cardiology
- Geriatrics
- Palliative Care
Background:
- Clinical guidelines for heart failure (HF) emphasize advance care planning and end-of-life preferences.
- Few studies have investigated these preferences in elderly HF patients or their prognostic implications.
Purpose of the Study:
- To assess the end-of-life preferences of elderly patients admitted for heart failure.
- To explore the relationship between these preferences and 6-month prognosis.
Main Methods:
- Observational, multicenter, survey-style study.
- Inclusion of 673 patients aged 75+ admitted for HF across 60 Spanish hospitals.
- 6-month follow-up recording mortality, emergency room visits, and readmissions.
Main Results:
- Majority (92%) prioritized quality of life over prolonged survival.
- Adequate symptom control (dyspnea, pain) was a key priority.
- Limited discussion (9%) and decision-making (29% against, 37% undecided) regarding cardiopulmonary resuscitation.
- None of the expressed end-of-life preferences independently predicted 6-month prognosis.
Conclusions:
- Elderly patients with heart failure and comorbidities prioritize quality of life and symptom management.
- Systematic and proactive advance care planning is crucial for this population.
- End-of-life preferences did not correlate with short-term prognosis in this cohort.
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