Which two prognostic risk scores are commonly used in heart failure to estimate mortality risk?

• A. NYHA class and ejection fraction
• B. MAGGIC Risk Score and Seattle Heart Failure Model; estimate mortality risk
• C. CHADS-VASc
• D. MELD

Answer: (B)

In heart failure prognosis, mortality risk is best estimated with multivariable risk scores that combine many patient factors, not a single measure. The MAGGIC Risk Score and the Seattle Heart Failure Model are two well-established tools that integrate variables such as age, functional class, ejection fraction, renal function, blood pressure, medications, device therapy, and lab values to estimate mortality risk over specific time horizons. They provide quantitative probabilities that help guide decisions like advanced therapies or transplant evaluation.

Relying on only NYHA class and ejection fraction misses much of the prognostic information captured by those models, because functional class and systolic function alone don’t account for the full clinical picture. CHADS-VASc is for stroke risk in atrial fibrillation, not heart failure mortality. MELD is used to assess liver disease severity, not heart failure prognosis.