Impact of Frailty and Disability on 30-Day Mortality in Older Patients With Acute Heart Failure.

The objectives were to determine the impact of frailty and disability on 30-day mortality and whether the addition of these variables to HFRSS EFFECT risk score (FBI-EFFECT model) improves the short-term mortality predictive capacity of both HFRSS EFFECT and BI-EFFECT models in older patients with a...

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Autores: Martín-Sánchez, Francisco Javier, Rodríguez-Adrada, Esther, Vidan, Maria Teresa, Llopis García, Guillermo, González Del Castillo, Juan, Rizzi, Miguel Alberto, Alquezar, Aitor, Piñera, Pascual, Lázaro Aragues, Paula, Llorens, Pere, Herrero, Pablo, Jacob, Javier, Gil, Víctor, Fernández, Cristina, Bueno, Hector, Miró, Òscar
Tipo de recurso: artículo
Fecha de publicación:2017
País:España
Institución:Instituto de Salud Carlos III (ISCIII)
Repositorio:Repisalud
Idioma:inglés
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/11303
Acceso en línea:http://hdl.handle.net/20.500.12105/11303
Access Level:acceso abierto
Palabra clave:Registries
Risk Assessment
Acute Disease
Aged
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spelling Impact of Frailty and Disability on 30-Day Mortality in Older Patients With Acute Heart Failure.Martín-Sánchez, Francisco JavierRodríguez-Adrada, EstherVidan, Maria TeresaLlopis García, GuillermoGonzález Del Castillo, JuanRizzi, Miguel AlbertoAlquezar, AitorPiñera, PascualLázaro Aragues, PaulaLlorens, PereHerrero, PabloJacob, JavierGil, VíctorFernández, CristinaBueno, HectorMiró, ÒscarRegistriesRisk AssessmentAcute DiseaseAgedThe objectives were to determine the impact of frailty and disability on 30-day mortality and whether the addition of these variables to HFRSS EFFECT risk score (FBI-EFFECT model) improves the short-term mortality predictive capacity of both HFRSS EFFECT and BI-EFFECT models in older patients with acute decompensated heart failure (ADHF) atended in the emergency department. We performed a retrospective analysis of OAK Registry including all consecutive patients ≥65 years old with ADHF attended in 3 Spanish emergency departments over 4 months. FBI-EFFECT model was developed by adjusting probabilities of HFRSS EFFECT risk categories according to the 6 groups (G1: non frail, no or mildly dependent; G2: frail, no or mildly dependent; G3: non frail, moderately dependent; G4: frail, moderately dependent; G5: severely dependent; G6: very severely dependent).We included 596 patients (mean age: 83 [SD7]; 61.2% females). The 30-day mortality was 11.6% with statistically significant differences in the 6 groups (p < 0.001). After adjusting for HFRSS EFFECT risk categories, we observed a progressive increase in hazard ratios from groups G2 to G6 compared with G1 (reference). FBI-EFFECT had a better prognostic accuracy than did HFRSS EFFECT (log-rank p < 0.001; Net Reclassification Improvement [NRI] = 0.355; p < 0.001; Integrated Discrimination Improvement [IDI] = 0.052; p ;< 0.001) and BI-EFFECT (log-rank p = 0.067; NRI = 0.210; p = 0.033; IDI = 0.017; p = 0.026). In conclusion, severe disability and frailty in patients with moderate disability are associated with 30-day mortality in ADHF, providing additional value to HFRSS EFFECT model in predicting short-term prognosis and establishing a care plan.ElsevierInstituto de Salud Carlos IIIUnión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF)Ministerio de Sanidad (España)Fundación La Marató TV320202020-11-0520172017-10-0120172017-10-01journal articlehttp://purl.org/coar/resource_type/c_6501AMhttp://purl.org/coar/version/c_ab4af688f83e57aainfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/20.500.12105/11303reponame:Repisaludinstname:Instituto de Salud Carlos III (ISCIII)InglésengES PI15 00773ES PI15 01019ES PI11 01021open accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:repisalud.isciii.es:20.500.12105/113032026-06-12T12:43:37Z
dc.title.none.fl_str_mv Impact of Frailty and Disability on 30-Day Mortality in Older Patients With Acute Heart Failure.
title Impact of Frailty and Disability on 30-Day Mortality in Older Patients With Acute Heart Failure.
spellingShingle Impact of Frailty and Disability on 30-Day Mortality in Older Patients With Acute Heart Failure.
Martín-Sánchez, Francisco Javier
Registries
Risk Assessment
Acute Disease
Aged
title_short Impact of Frailty and Disability on 30-Day Mortality in Older Patients With Acute Heart Failure.
title_full Impact of Frailty and Disability on 30-Day Mortality in Older Patients With Acute Heart Failure.
title_fullStr Impact of Frailty and Disability on 30-Day Mortality in Older Patients With Acute Heart Failure.
title_full_unstemmed Impact of Frailty and Disability on 30-Day Mortality in Older Patients With Acute Heart Failure.
title_sort Impact of Frailty and Disability on 30-Day Mortality in Older Patients With Acute Heart Failure.
dc.creator.none.fl_str_mv Martín-Sánchez, Francisco Javier
Rodríguez-Adrada, Esther
Vidan, Maria Teresa
Llopis García, Guillermo
González Del Castillo, Juan
Rizzi, Miguel Alberto
Alquezar, Aitor
Piñera, Pascual
Lázaro Aragues, Paula
Llorens, Pere
Herrero, Pablo
Jacob, Javier
Gil, Víctor
Fernández, Cristina
Bueno, Hector
Miró, Òscar
author Martín-Sánchez, Francisco Javier
author_facet Martín-Sánchez, Francisco Javier
Rodríguez-Adrada, Esther
Vidan, Maria Teresa
Llopis García, Guillermo
González Del Castillo, Juan
Rizzi, Miguel Alberto
Alquezar, Aitor
Piñera, Pascual
Lázaro Aragues, Paula
Llorens, Pere
Herrero, Pablo
Jacob, Javier
Gil, Víctor
Fernández, Cristina
Bueno, Hector
Miró, Òscar
author_role author
author2 Rodríguez-Adrada, Esther
Vidan, Maria Teresa
Llopis García, Guillermo
González Del Castillo, Juan
Rizzi, Miguel Alberto
Alquezar, Aitor
Piñera, Pascual
Lázaro Aragues, Paula
Llorens, Pere
Herrero, Pablo
Jacob, Javier
Gil, Víctor
Fernández, Cristina
Bueno, Hector
Miró, Òscar
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Instituto de Salud Carlos III
Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF)
Ministerio de Sanidad (España)
Fundación La Marató TV3
dc.subject.none.fl_str_mv Registries
Risk Assessment
Acute Disease
Aged
topic Registries
Risk Assessment
Acute Disease
Aged
description The objectives were to determine the impact of frailty and disability on 30-day mortality and whether the addition of these variables to HFRSS EFFECT risk score (FBI-EFFECT model) improves the short-term mortality predictive capacity of both HFRSS EFFECT and BI-EFFECT models in older patients with acute decompensated heart failure (ADHF) atended in the emergency department. We performed a retrospective analysis of OAK Registry including all consecutive patients ≥65 years old with ADHF attended in 3 Spanish emergency departments over 4 months. FBI-EFFECT model was developed by adjusting probabilities of HFRSS EFFECT risk categories according to the 6 groups (G1: non frail, no or mildly dependent; G2: frail, no or mildly dependent; G3: non frail, moderately dependent; G4: frail, moderately dependent; G5: severely dependent; G6: very severely dependent).We included 596 patients (mean age: 83 [SD7]; 61.2% females). The 30-day mortality was 11.6% with statistically significant differences in the 6 groups (p < 0.001). After adjusting for HFRSS EFFECT risk categories, we observed a progressive increase in hazard ratios from groups G2 to G6 compared with G1 (reference). FBI-EFFECT had a better prognostic accuracy than did HFRSS EFFECT (log-rank p < 0.001; Net Reclassification Improvement [NRI] = 0.355; p < 0.001; Integrated Discrimination Improvement [IDI] = 0.052; p ;< 0.001) and BI-EFFECT (log-rank p = 0.067; NRI = 0.210; p = 0.033; IDI = 0.017; p = 0.026). In conclusion, severe disability and frailty in patients with moderate disability are associated with 30-day mortality in ADHF, providing additional value to HFRSS EFFECT model in predicting short-term prognosis and establishing a care plan.
publishDate 2017
dc.date.none.fl_str_mv 2017
2017-10-01
2017
2017-10-01
2020
2020-11-05
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
AM
http://purl.org/coar/version/c_ab4af688f83e57aa
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/20.500.12105/11303
url http://hdl.handle.net/20.500.12105/11303
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.relation.none.fl_str_mv ES PI15 00773
ES PI15 01019
ES PI11 01021
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 Internacional
http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 Internacional
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repisalud
instname:Instituto de Salud Carlos III (ISCIII)
instname_str Instituto de Salud Carlos III (ISCIII)
reponame_str Repisalud
collection Repisalud
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.812429

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