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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The interesting article by Costantini et al¹ on the impact of a guideline-based management on outcomes of hospitalized patients with heart failure calls for additional data in other subsets of decompensated patients. We report our experience on very old persons living in long-term care facilities, where prevalence rates of heart failure are particularly high and adherence to guideline² recommendations on pharmacological treatment poor.³

In 2000, we tried to reduce hospital admission for diagnosis related group (DRG) 127 through an active application of guideline recommendations among 68 subjects (mean ± SD age, 87 ± 4 years; 75% women) living in a nursing home in Venetia, Italy. First, a consultant cardiologist along with both the practitioner and nurses responsible for the nursing home reviewed each subject's data, showing that (1) both prevalence of heart failure and hospitalization rate for DRG 127 in 1999 were high (20% and 13%, respectively); (2) ACE inhibitors, . . . [Full Text of this Article]

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