Basal functional status predicts one-year mortality after a heart failure hospitalization in elderly patients - The RICA prospective study
| Autor: | José Pérez-Silvestre, Margarita Carrera, Melitón Francisco Dávila, Alicia Conde-Martel, Luis Manzano, Francesc Formiga, Xavier Corbella, Oscar Aramburu, Manuel Montero-Pérez-Barquero, David Chivite |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Family support 030204 cardiovascular system & hematology Logistic regression 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Internal medicine Medicine Humans 030212 general & internal medicine Prospective Studies Registries Mortality Prospective cohort study Aged Aged 80 and over Heart Failure Ejection fraction business.industry Recovery of Function medicine.disease Pulmonary edema Hospitalization Spain Heart failure Predictive value of tests Female Cardiology and Cardiovascular Medicine business Kidney disease Follow-Up Studies |
| Zdroj: | International journal of cardiology. 254 |
| ISSN: | 1874-1754 |
| Popis: | Background Dependence for basic activities of the daily living (ADL) relates to adverse outcomes in elderly acute heart failure (AHF) patients. Methods We evaluated patients ≥75years admitted because of AHF, divided according to preadmission Barthel Index (BI) category: severe (BI 0–60), moderate (BI 61–90) and slight dependence or independence for basic ADL (BI 91–100). We compared their baseline characteristics and used logistic regression models to determine whether a BI≤60 confers higher one-year mortality risk. Results We included 2195 patients, mean age 83years; 57% women, Charlson Index 3, 65% with preserved left ventricular ejection fraction. Their median preadmission BI was 90 (65–100); 21.7% had BI≤60. Patients with BI≤60 were older, more often females, with higher comorbid and cognitive burden and more likely to be institutionalized. 560 patients (26%) died within the follow-up period. A preadmission BI≤60 was significantly associated with higher risk of 12-month mortality (HR 1.42, 95% CI 1.14–1.77) together with male sex (1.27, 1.04–1.54), valve disease (1.49, 1.20–1.83), worse preadmission NYHA class (1.44, 1.20–1.73), stage IV chronic kidney disease (1.70, 1.35–2.15), pulmonary edema (1.33, 1.01–1.76), no family support (1.47, 1.06–2.06), and higher Charlson Comorbidity Index (1.09, CI 1.05–1.13) and Pfeiffer cognitive screening questionnaire scores (1.10, 1.05–1.14). Conclusion Among elderly AHF patients, the presence of severe (BI≤60) preadmission dependence for basic ADL confers a significant and independent risk of one-year post-discharge mortality. |
| Databáze: | OpenAIRE |
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