Basal functional status predicts three-month mortality after a heart failure hospitalization in elderly patients — The prospective RICA study
| Autor: | Francesc, Formiga, David, Chivite, Alicia, Conde, Fernando, Ruiz-Laiglesia, Alvaro González, Franco, Carmen Pérez, Bocanegra, Luis, Manzano, Manuel Montero, Pérez-Barquero, A, Urrutia |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Barthel index Population Comorbidity Kaplan-Meier Estimate Basal (phylogenetics) Older patients Predictive Value of Tests Internal medicine Medical Staff Hospital medicine Humans Decompensation Prospective Studies Intensive care medicine education Aged Proportional Hazards Models Aged 80 and over Heart Failure education.field_of_study business.industry medicine.disease Hospitalization Heart failure Heart Function Tests Cohort Female Functional status Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | International Journal of Cardiology. 172:127-131 |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/j.ijcard.2013.12.169 |
| Popis: | Many elderly heart failure (HF) patients show some degree of functional impairment. The study aim was to evaluate the functional status of oldest-old cohort of patients hospitalized with a diagnosis of decompensated (HF), and to analyze whether preadmission functional status predicts risk of 3-month mortality.We analyzed 1431 elderly (≥ 75 years) patients prospectively included in the Spanish National Registry on HF (RICA). We added Barthel Index (BI) to the usual HF patient assessment to measure patients' functional status, and we evaluated the relationship between preadmission BI values and 3-month mortality.The mean age of patients was 82.3 (4.6) years. Patients' mean preadmission BI score was 81.3 (21.5); 802 patients (55.9%) had BI scores61. Multivariate analysis confirmed an independent association between poor preadmission BI and older age, female sex, higher comorbidity, cognitive impairment, previous institutionalization, worse New York Heart Association (NYHA) functional class and lack of beta-blocker use. A total of 210 patients died (14.7%) after 3 months of follow-up. Cox multivariate analyses found that higher preadmission BI is correlated with reduced all-cause, 3-month postdischarge mortality [hazard ratio (HR) 0.981; CI95% 0.975-0.986, p0.001]. Other variables independently associated with 3-month mortality were male sex, lower body mass index, lower systolic blood pressure, a diagnosis of diabetes and chronic kidney disease, worse NYHA class and not receiving treatment with beta-blockers.Severe functional disability is present among more than half of older patients admitted because of a HF decompensation. For this population, preadmission BI is a strong predictor of short-term mortality. |
| Databáze: | OpenAIRE |
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