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: Martin-Sanchez, FJ, Rodriguez-Adrada, E, Vidan, MT, Garcia, GL, del Castillo, JG, Rizzi, MA, Alquezar, A, Pinera, P, Aragues, PL, Llorens, P, Herrero, P, Jacob, J, Gil, V, Fernandez, C, Bueno, H, Miro, O
Tipo de documento: artigo
Estado:Versão publicada
Data de publicação:2017
País:España
Recursos:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositório:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p6127
Acesso em linha:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=6127
http://hdl.handle.net/20.500.12105/11303
Access Level:Acceso aberto
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spelling Impact of Frailty and Disability on 30-Day Mortality in Older Patients With Acute Heart FailureMartin-Sanchez, FJRodriguez-Adrada, EVidan, MTGarcia, GLdel Castillo, JGRizzi, MAAlquezar, APinera, PAragues, PLLlorens, PHerrero, PJacob, JGil, VFernandez, CBueno, HMiro, OThe 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 (Gl: 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. (C) 2017 Elsevier Inc. All rights reserved.EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC2017info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=6127http://hdl.handle.net/20.500.12105/11303AMERICAN JOURNAL OF CARDIOLOGYISSN: 00029149ISSNe: 18791913reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p61272026-06-14T12:41:47Z
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
Martin-Sanchez, FJ
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 Martin-Sanchez, FJ
Rodriguez-Adrada, E
Vidan, MT
Garcia, GL
del Castillo, JG
Rizzi, MA
Alquezar, A
Pinera, P
Aragues, PL
Llorens, P
Herrero, P
Jacob, J
Gil, V
Fernandez, C
Bueno, H
Miro, O
author Martin-Sanchez, FJ
author_facet Martin-Sanchez, FJ
Rodriguez-Adrada, E
Vidan, MT
Garcia, GL
del Castillo, JG
Rizzi, MA
Alquezar, A
Pinera, P
Aragues, PL
Llorens, P
Herrero, P
Jacob, J
Gil, V
Fernandez, C
Bueno, H
Miro, O
author_role author
author2 Rodriguez-Adrada, E
Vidan, MT
Garcia, GL
del Castillo, JG
Rizzi, MA
Alquezar, A
Pinera, P
Aragues, PL
Llorens, P
Herrero, P
Jacob, J
Gil, V
Fernandez, C
Bueno, H
Miro, O
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
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 (Gl: 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. (C) 2017 Elsevier Inc. All rights reserved.
publishDate 2017
dc.date.none.fl_str_mv 2017
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=6127
http://hdl.handle.net/20.500.12105/11303
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=6127
http://hdl.handle.net/20.500.12105/11303
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
publisher.none.fl_str_mv EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
dc.source.none.fl_str_mv AMERICAN JOURNAL OF CARDIOLOGY
ISSN: 00029149
ISSNe: 18791913
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
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