Impact of geriatric assessment variables on 30-day mortality among older patients with acute heart failure
Por:
Javier Martin-Sanchez, F, Rodríguez-Adrada E, Teresa Vidan, M, Díez Villanueva P, Llopis García G, González Del Castillo J, Alberto Rizzi M, Alquézar A, Herrera Mateo S, Pinera, P, Sánchez Nicolás JA, Lázaro Aragues P, Llorens P, Herrero P, Jacob J, Gill, V, Fernandez, C, Bueno, H and Miro, O
Publicada:
1 jun 2018
Categoría:
Emergency medicine
Resumen:
Objective. 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).
Conclusions. Certain geriatric variables should be considered when assessing short-term risk in older patients with AHF.
Filiaciones:
Javier Martin-Sanchez, F:
Hosp Clin San Carlos, Serv Urgencias, Calle Prof Martin Lagos S-N, Madrid 28040, Spain
Univ Complutense, Inst Invest Sanitaria, Hosp Clin San Carlos IdISSC, Madrid, Spain
Rodríguez-Adrada E:
Univ Complutense, Inst Invest Sanitaria, Hosp Clin San Carlos IdISSC, Madrid, Spain
Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Universidad Complutense, Madrid, España
Teresa Vidan, M:
Univ Complutense Madrid, Inst Invest IiSGM, Hosp Gregorio Maranon, Serv Geriatria, Madrid, Spain
Díez Villanueva P:
Hosp Univ La Princesa, Serv Cardiol, Madrid, Spain
Servicio de Cardiología, Hospital Universitario La Princesa, Madrid, España
Llopis García G:
Hosp Clin San Carlos, Serv Urgencias, Calle Prof Martin Lagos S-N, Madrid 28040, Spain
Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, España
González Del Castillo J:
Hosp Clin San Carlos, Serv Urgencias, Calle Prof Martin Lagos S-N, Madrid 28040, Spain
Univ Complutense, Inst Invest Sanitaria, Hosp Clin San Carlos IdISSC, Madrid, Spain
Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, España. Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Universidad Complutense, Madrid, España
Alberto Rizzi M:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Serv Urgencias, Barcelona, Spain
Servicio de Urgencias, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, España
Alquézar A:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Serv Urgencias, Barcelona, Spain
Servicio de Urgencias, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, España
Herrera Mateo S:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Serv Urgencias, Barcelona, Spain
Servicio de Urgencias, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, España
Pinera, P:
Hosp Reina Sofia, Serv Urgencias, Murcia, Spain
Sánchez Nicolás JA:
Hosp Reina Sofia, Serv Urgencias, Murcia, Spain
Servicio de Urgencias, Hospital Reina Sofía, Murcia, España
Lázaro Aragues P:
Hosp Reina Sofia, Serv Urgencias, Murcia, Spain
Servicio de Urgencias, Hospital Reina Sofía, Murcia, España
:
Univ Miguel Hernandez Alicante, Serv Urgencias, Hosp Gen Alicante, Inst Invest Sanitaria & Biomed Alicante ISABIAL F, Alicante, Spain
Servicio de Urgencias, Hospital General de Alicante
Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIALFundación FISABIO), Universidad Miguel Hernández de Alicante, España
Herrero P:
Hosp Cent Asturias, Serv Urgencias, Oviedo, Spain
Servicio de Urgencias, Hospital Central de Asturias, Oviedo, España
Jacob J:
Hosp Univ Bellvitge, Serv Urgencias, Barcelona, Spain
Gill, V:
Univ Barcelona, Inst Recerca Biomed August Pi I Sunyer IDIBAPS, Hosp Clin, Area Urgencias, Barcelona, Spain
Fernandez, C:
Univ Complutense, Inst Invest Sanitaria, Hosp Clin San Carlos IdISSC, Madrid, Spain
Hosp Clin San Carlos, Serv Med Prevent, Madrid, Spain
Bueno, H:
CNIC, Madrid, Spain
Hosp Univ 12 Octubre, Inst Invest I 12, Serv Cardiol, Madrid, Spain
Univ Complutense Madrid, Madrid, Spain
Miro, O:
Univ Barcelona, Inst Recerca Biomed August Pi I Sunyer IDIBAPS, Hosp Clin, Area Urgencias, Barcelona, Spain
Servicio de Geriatría, Hospital Gregorio Marañón, Instituto de Investigación IiSGM, Universidad Complutense de Madrid, España
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