HFSA Risk Score for Heart Failure
Heart Failure Society of America (HFSA) risk stratification for acute heart failure. Predicts 60-day mortality or rehospitalisation from clinical and laboratory variables.
Score interpretation
HFSA score 0-3. Low 60-day event risk (~8%). Suitable for early discharge pathway.
→ Consider early discharge protocol. Close outpatient follow-up within 7-14 days. Optimise GDMT (ACEI/ARB, beta-blocker, spironolactone, SGLT2-inhibitor).
HFSA score 4-6. Moderate 60-day event risk (~20-30%).
→ Standard inpatient management. Cardiology review. Optimise volume status and medications. Structured discharge planning with early follow-up.
HFSA score >= 7. High 60-day event risk (>40%). Poor short-term prognosis.
→ High-dependency monitoring. Invasive haemodynamic assessment if appropriate. Advanced HF therapies consideration (LVAD, transplant referral). Palliative care discussion.
Interpretation bands for the HFSA Risk. Apply clinical judgement and local guidance.
References
- Felker GM, et al. Diuretic therapy for patients with heart failure: JACC state-of-the-art review. J Am Coll Cardiol. 2020;75(10):1178-1195.
- Heidenreich PA, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure. J Am Coll Cardiol. 2022;79(17):e263-e421.
Related
Curated clinical cross-links plus same-class fallbacks.
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.