In hospitals, mortality ranges from 2% to 20% depending on clinical factors found on admission.[116]Fonarow GC, Adams KF Jr, Abraham WT, et al. Risk stratification for in-hospital mortality in acutely decompensated heart failure: classification and regression tree analysis. JAMA. 2005 Feb 2;293(5):572-80.
http://jama.ama-assn.org/cgi/content/full/293/5/572
http://www.ncbi.nlm.nih.gov/pubmed/15687312?tool=bestpractice.com
Predictors of adverse outcomes include: hypotension, renal dysfunction, older age, male sex, ischemic congestive heart failure (CHF), previous CHF, respiratory rate on admission >30/minute, anemia, hyponatremia, elevated troponin, elevated B-type natriuretic peptide, and other comorbidities such as cancer.[117]Dec GW. Management of acute decompensated heart failure. Curr Probl Cardiol. 2007 Jun;32(6):321-66.
http://www.ncbi.nlm.nih.gov/pubmed/17531903?tool=bestpractice.com
One study found that among patients hospitalized with heart failure, patients across the ejection fraction spectrum have a similarly poor 5-year survival with an elevated risk for cardiovascular and heart failure admission.[118]Shah KS, Xu H, Matsouaka RA, et al. Heart failure with preserved, borderline, and reduced ejection fraction: 5-year outcomes. J Am Coll Cardiol. 2017 Nov 14;70(20):2476-86.
http://www.ncbi.nlm.nih.gov/pubmed/29141781?tool=bestpractice.com
All patients in this cohort, regardless of ejection fraction, had a remarkably high mortality rate at 5 years from index admission (75.4%).[118]Shah KS, Xu H, Matsouaka RA, et al. Heart failure with preserved, borderline, and reduced ejection fraction: 5-year outcomes. J Am Coll Cardiol. 2017 Nov 14;70(20):2476-86.
http://www.ncbi.nlm.nih.gov/pubmed/29141781?tool=bestpractice.com
One meta-analysis has shown that presence of wide QRS or bundle branch block (BBB) is associated with a modest increase in the risk of all cause mortality in patients with acute heart failure (irrespective of the type of BBB).[119]Aguiló O, Castells X, Miró Ò, et al. The prognostic significance of bundle branch block in acute heart failure: a systematic review and meta-analysis. Clin Res Cardiol. 2023 Aug;112(8):1020-43.
http://www.ncbi.nlm.nih.gov/pubmed/36116092?tool=bestpractice.com