• Nicholas R Jones, Andrea K Roalfe, Ibiye Adoki, Richard Hobbs F D FD Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock , and Clare J Taylor.
• Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Rd, Oxford, OX2 6GG, England.
• Syst Rev. 2018 Oct 3; 7 (1): 151.

BackgroundHeart failure (HF) is a common condition affecting more than 10% of those over 70 years of age. Reliable estimates of survival following a diagnosis of HF are important to guide management and facilitate advanced care planning. Most existing research has focused on survival rates for patients admitted to hospital with acute HF. However, the majority of patients with HF are diagnosed in the outpatient setting and can have periods of sustained symptom stability in the chronic phase of their illness. There has not been a systematic review of the literature to determine the prognosis of patients with chronic HF in the community.MethodsWe will undertake a comprehensive search of the following databases: CINAHL, Database of Abstracts of Reviews of Effects, Embase, MEDLINE and the Clinical Trials Register ( clinicaltrials.gov ). Two reviewers will independently complete screening, data extraction and quality appraisal with the option of input from a third reviewer to arbitrate. We will include data from observational or database studies conducted in either community or outpatient settings. Studies of acute HF or specific subgroups of patients will be excluded. There is no restriction by geographical setting, publication language or study date. We will complete QUIPS and GRADE assessments to systematically appraise the quality of evidence within and between studies. Where possible, we will seek to pool results to conduct a meta-analysis and undertake relevant subgroup analysis including by study setting, participant age and study decade. The primary outcome will be survival time from diagnosis. The secondary outcomes will be HF-related hospital admissions, symptom burden and measures of morbidity.DiscussionThis systematic review will provide up to date evidence on the current survival rates and prognostic indicators for patients with chronic HF. We will put this into historical perspective, comparing outcomes across time to help understand the impact of advances in evidence-based treatment on average survival. This information is important in facilitating informed decision-making for patients and health professionals as well as highlighting areas to focus resources and improve public health planning.Systematic Review RegistrationPROSPERO 2017 CRD42017075680.

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