OBJECTIVE: To assess the prevalence of major geriatric syndromes (MGSs)-frailty, cognitive impairment, severe dependence and depression-and their influence on outcomes in unselected patients with acute cardiac diseases. DESIGN: Observational prospective study with 12-month clinical and functional follow-up. SETTING: Clinical cardiology unit of a university hospital in Madrid, Spain. PATIENTS: Consecutive patients ≥75 years old urgently admitted to the cardiology unit. INTERVENTION: Systematic comprehensive geriatric assessment. MAIN OUTCOME MEASURES: 12-month rates of mortality, readmission, functional decline and need for new social help. RESULTS: Among the 211 patients studied, 127 (60.2%) presented at least one MGS on admission: 86 frailty (40.8%), 67 cognitive impairment (31.8%), 31 severe dependency (14.7%) and 9 depression (4.3%). Patients with MGSs were slightly older (82±5 vs 81±4 years, p=0.02) but did not show greater disease severity or comorbidity. The presence of MGSs was associated with a higher incidence of functional decline during hospitalisation (35.7% vs 8.6%, p=0.002) and higher 12-month age-, comorbidity- and diagnosis-adjusted risks of readmission (OR, 2.1.92; 95% CI 0.98 to 3.7), functional decline (OR, 2.86; 95% CI 1.41 to 5.79) and need for new social help (OR, 3.10; 95% CI 1.45 to 6.60). MGSs were also associated with a higher 12-month mortality rate, which was only obvious in patients hospitalised for heart failure but not for other reasons. CONCLUSIONS: A majority of older patients hospitalised for acute cardiac conditions in a cardiology department show at least one MGS on admission. MGSs are associated with poorer inhospital and postdischarge functional and clinical outcomes, particularly in patients with heart failure.
OBJECTIVE: To assess the prevalence of major geriatric syndromes (MGSs)-frailty, cognitive impairment, severe dependence and depression-and their influence on outcomes in unselected patients with acute cardiac diseases. DESIGN: Observational prospective study with 12-month clinical and functional follow-up. SETTING: Clinical cardiology unit of a university hospital in Madrid, Spain. PATIENTS: Consecutive patients ≥75 years old urgently admitted to the cardiology unit. INTERVENTION: Systematic comprehensive geriatric assessment. MAIN OUTCOME MEASURES: 12-month rates of mortality, readmission, functional decline and need for new social help. RESULTS: Among the 211 patients studied, 127 (60.2%) presented at least one MGS on admission: 86 frailty (40.8%), 67 cognitive impairment (31.8%), 31 severe dependency (14.7%) and 9 depression (4.3%). Patients with MGSs were slightly older (82±5 vs 81±4 years, p=0.02) but did not show greater disease severity or comorbidity. The presence of MGSs was associated with a higher incidence of functional decline during hospitalisation (35.7% vs 8.6%, p=0.002) and higher 12-month age-, comorbidity- and diagnosis-adjusted risks of readmission (OR, 2.1.92; 95% CI 0.98 to 3.7), functional decline (OR, 2.86; 95% CI 1.41 to 5.79) and need for new social help (OR, 3.10; 95% CI 1.45 to 6.60). MGSs were also associated with a higher 12-month mortality rate, which was only obvious in patients hospitalised for heart failure but not for other reasons. CONCLUSIONS: A majority of older patients hospitalised for acute cardiac conditions in a cardiology department show at least one MGS on admission. MGSs are associated with poorer inhospital and postdischarge functional and clinical outcomes, particularly in patients with heart failure.
Authors: Haider J Warraich; Dalane W Kitzman; David J Whellan; Pamela W Duncan; Robert J Mentz; Amy M Pastva; M Benjamin Nelson; Bharathi Upadhya; Gordon R Reeves Journal: Circ Heart Fail Date: 2018-11 Impact factor: 8.790
Authors: Quin E Denfeld; Kerri Winters-Stone; James O Mudd; Jill M Gelow; Sawsan Kurdi; Christopher S Lee Journal: Int J Cardiol Date: 2017-02-10 Impact factor: 4.164
Authors: Mathew S Maurer; Evelyn Horn; Alex Reyentovich; Victoria Vaughan Dickson; Sean Pinney; Deena Goldwater; Nathan E Goldstein; Omar Jimenez; Sergio Teruya; Jeff Goldsmith; Stephen Helmke; Melana Yuzefpolskaya; Gordon R Reeves Journal: J Am Geriatr Soc Date: 2017-09-21 Impact factor: 5.562
Authors: Gordon R Reeves; David J Whellan; Mahesh J Patel; Christopher M O'Connor; Pamela Duncan; Joel D Eggebeen; Timothy M Morgan; Leigh A Hewston; Amy M Pastva; Dalane W Kitzman Journal: Am J Cardiol Date: 2016-04-06 Impact factor: 2.778
Authors: C Barrett Bowling; John N Booth; Orlando M Gutiérrez; Manjula Kurella Tamura; Lei Huang; Meredith Kilgore; Suzanne Judd; David G Warnock; William M McClellan; Richard M Allman; Paul Muntner Journal: Clin J Am Soc Nephrol Date: 2014-10-02 Impact factor: 8.237
Authors: Andrea L Rosso; Charles B Eaton; Robert Wallace; Rachel Gold; Marcia L Stefanick; Judith K Ockene; J David Curb; Yvonne L Michael Journal: J Am Geriatr Soc Date: 2013-03-01 Impact factor: 5.562
Authors: Francisco J Martín-Sánchez; Michael Christ; Òscar Miró; W Frank Peacock; John J McMurray; Héctor Bueno; Alan S Maisel; Louise Cullen; Martin R Cowie; Salvatore Di Somma; Elke Platz; Josep Masip; Uwe Zeymer; Christiaan Vrints; Susanna Price; Christian Mueller Journal: Int J Cardiol Date: 2016-07-18 Impact factor: 4.164
Authors: Gordon R Reeves; David J Whellan; Christopher M O'Connor; Pamela Duncan; Joel D Eggebeen; Timothy M Morgan; Leigh Ann Hewston; Amy Pastva; Mahesh J Patel; Dalane W Kitzman Journal: JACC Heart Fail Date: 2017-03-08 Impact factor: 12.035