Short-term mortality in end-stage heart failure patients
| Autor: | Verdú-Rotellar, Jose Maria, Calero, Esther, Abellana, Rosa, Verdú-Soriano, José, Vinyoles, Ernest, Del Val García, José Luis, Domingo, Mar, Muñoz, Miguel-Angel, Universitat Autònoma de Barcelona |
|---|---|
| Přispěvatelé: | Universidad de Alicante. Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia, Grupo Balmis de Investigación en Salud Comunitaria e Historia de la Ciencia |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Heart diseases Epidemiology Renal function Factores pronósticos Angiotensin-Converting Enzyme Inhibitors Heart failure 030204 cardiovascular system & hematology Logistic regression Prognostic factors Malalties del cor Cohort Studies Angiotensin Receptor Antagonists 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Mortalitat medicine Risk of mortality Humans Epidemiología 030212 general & internal medicine Mortality Risk factor Aged Aged 80 and over Heart Failure lcsh:R5-920 business.industry Insuficiencia cardíaca General Medicine Originales medicine.disease Blood pressure End of life Female Enfermería lcsh:Medicine (General) Family Practice business Body mass index Cohort study Fin de vida |
| Zdroj: | Dipòsit Digital de Documents de la UAB Universitat Autònoma de Barcelona Dipòsit Digital de la UB Universidad de Barcelona RUA. Repositorio Institucional de la Universidad de Alicante Universidad de Alicante (UA) Atencion Primaria r-IGTP. Repositorio Institucional de Producción Científica del Instituto de Investigación Germans Trias i Pujol instname Atención Primaria, Vol 52, Iss 7, Pp 477-487 (2020) |
| ISSN: | 0212-6567 |
| Popis: | Objectives: This study is aimed at analyzing the impact of the main factors contributing to short and long-term mortality in patients at final stages of heart failure (HF). Setting: Patients attended at any of the 279 primary health care centers belonging to the Institut Català de la Salut, in Catalonia (Spain). Participants: Patients with Advanced HF. Design: Multicenter cohort study including 1148 HF patients followed for one-year after reaching New York Heart Association (NYHA) IV. Main measurements: The primary outcome was all-cause mortality. Multivariate logistic regression models were performed to assess the outcomes at 1, 3, 6, and 12 months. Results: Mean age of patients was 82 (SD 9) years and women represented 61.7%. A total of 135 (11.8%) and 397 (34.6%) patients died three months and one year after inclusion, respectively. Male gender, age, and decreased body mass index were associated with higher mortality at three, six and twelve months. In addition, low systolic blood pressure levels, severe reduction in glomerular filtration, malignancy, and higher doses of loop diuretics were related to higher mortality from 6 to 12 months.The most important risk factor over the whole period was presenting a body mass index lower than 20 kg/m2 (three months OR 3.06, 95% CI: 1.58–5.92; six months OR 4.42, 95% CI: 2.08–9.38; and 12 months OR 3.68, 95% CI: 1.76–7.69). Conclusions: We may conclude that male, age, and decreased body mass index determined higher short-term mortality in NYHA IV. In addition, low systolic blood pressure, reduced glomerular filtration, malignancy, and higher doses of loop diuretics contribute to increasing the risk of mortality at medium and long-term. Such variables are easily measurable and can help to decide the best way to face the most advances stages of the disease. Resumen: Objetivos: Analizar los factores que contribuyen a la mortalidad de pacientes en las etapas finales de la insuficiencia cardiaca (IC). Ámbito: Centros de atención primaria del Institut Català de la Salut, Cataluña, España. Participantes: Pacientes con IC avanzada. Diseño: Estudio de cohortes multicéntrico. Incluyó 1.148 pacientes de IC seguidos durante un año tras el registro de estadio funcional NYHA IV. Mediciones principales: El resultado principal fue la mortalidad por todas las causas. Se realizaron modelos de regresión logística multivariada (1, 3, 6 y 12 meses). Resultados: Edad media 82 años (DE 9), las mujeres representaron el 61,7%. Un total de 135 (11,8%) y 397 (34,6%) pacientes murieron 3 meses y un año después de su inclusión. El sexo masculino, la edad y el índice de masa corporal (IMC) |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|