We have greatly enjoyed reading the recently published manuscript by Biagi et al. [1] related with clinical profile and predictors of in-hospital outcome in patients with heart failure. In this report, functional and cognitive statuses were found to have important influence on patients' outcome. However, systolic blood pressure (SBP) b100 mm Hg, pulse pressure ≥55 mm Hg, and the presence of anemia or permanent bed rest were also found to be significantly related to negative outcomes. It is a fact that heart failure is a universally prevalent, moneyconsuming, and long-standing condition associated with heavy symptom burden, high mortality, and frequent hospital admission [2,3]. Moreover, the mean age of patients with this syndrome is getting older with accompanying comorbidities related with the senility. In this present study [1], the mean age of patients was nearly 79 years and only 10% of patients had isolated heart failure. Although the comorbidities could be the reason for longer hospital stay and also could be the marker of poor outcome and mortality, in this study [1] it was shown that the type rather than the number of comorbidities influenced the outcome. In a recent study [4], consistent with other published reports, increased serum creatinine, older age, increased heart rate, liver disease, cerebrovascular disease, low SBP, and low serum sodium were all found to be associated with in-hospital mortality in patients who were hospitalized for heart failure. In the study of Biagi et al. [1], although glomerular filtration rate and low natremiawere not significantly related toworse outcome, anemia and Barthel Index≤30which is a reliable measure of disability were found to be the predictors of poor outcome. Anemia was thought to be the result of associated comorbidities, whereas low Barthel Index could be associated with low systolic blood pressure, brain deficit or permanent bed rest which were also found to be significantly related to negative outcomes. Despite numerous advances in the treatment of chronic heart failure, the high risk of mortality in patients hospitalized for worsening heart failure is still ongoing. In this present study [1], it was reported that drugs whose mortality benefit was established in heart failure were underused at hospital admission. On the other hand, Abraham et al. [4] reported that patients taking an angiotensin-converting enzyme inhibitor or beta-blocker at the time of admission faced lower risk of inhospital mortality. In addition to the comorbidities and the aging heart failure population, the presence of suboptimal medical therapy can also influence the patient's poor outcome. In our opinion, the results of the present study suggest that the inhospital outcome of patients hospitalized for heart failure can be identified with laboratory data, demographic data and vital signs on hospital admission. Identification of high risk patients can alert physicians to target interventions to reduce the short term mortality and also may help them to tailor treatment strategies for improving the long term outcomes. The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology.