Impact of geriatric assessment variables on 30-day mortality among older patients with acute heart failure

Objetive: To study the impact of geriatric assessment variables on 30-day mortality among older patients with acute heart failure (AHF). Methods: Retrospective analysis of cases in the OAK Registry (Older Acute Heart Failure Key Data), a prospectively compiled database of consecutive patients aged 6...

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Detalles Bibliográficos
Autores: Martín-Sánchez, Francisco Javier, Rodríguez-Adrada, Esther, Vidán, Ma. Teresa, Díez Villanueva, Pablo, Llopis García, Guillermo, González del Castillo, Juan, Alberto Rizzi, Miguel, Alquézar Arbé, Aitor, Herrera Mateo, Sergio, Piñera, Pascual, Sánchez Nicolás, José Andrés, Lazaro Aragues, Paula, Llorens, Pere, Herrero, Pablo, Jacob, Javier, Gil, Víctor, Fernandez, Cristina, Bueno, Héctor, Miró i Andreu, Òscar
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2018
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/185896
Acceso en línea:https://hdl.handle.net/2445/185896
Access Level:acceso abierto
Palabra clave:Mortalitat
Insuficiència cardíaca
Pacients
Persones grans
Mortality
Heart failure
Patients
Older people
Descripción
Sumario:Objetive: To study the impact of geriatric assessment variables on 30-day mortality among older patients with acute heart failure (AHF). Methods: Retrospective analysis of cases in the OAK Registry (Older Acute Heart Failure Key Data), a prospectively compiled database of consecutive patients aged 65 years or older treated for AHF in 3 Spanish emergency departments over a 4-month period (November-December 2011 and January-February 2014). The patients underwent a geriatric assessment adapted for emergency department use on weekdays between 8 AM and 10 PM. Demographic, clinical, laboratory, and geriatric assessment variables were recorded. The geriatric variables were concurrent diseases; polypharmacy; frailty; functional, social, and cognitive status at baseline; results of screening for confusional state, cognitive impairment, and depression; and nutritional status. The primary outcome was all-cause mortality at 30 days. Results: We included 565 patients with a mean (SD) age of 83 (7.1) years; 346 (61.6%) were women. Sixty-five (11.5%) died within 30 days. Independent factors associated with 30-day mortality were acute confusional state (adjusted odds ratio [aOR], 2.2; 95% CI, 1.0-4.8; P=.04), acute illness (aOR, 1.8; 95% CI, 0.9-3.4; P=.05), loss of appetite in the past 3 months (aOR, 1.8; 95% CI, 1.0-3.4; P=.04), frailty (aOR, 2.0, 95% CI, 1.0-4.1; P=.05), and severe disability (aOR, 4.4; 95% CI, 1.9-11.4; P=.01).

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