Francesc Formiga1, David Chivite2, Alicia Conde3, Fernando Ruiz-Laiglesia4, Alvaro González Franco5, Carmen Pérez Bocanegra6, Luis Manzano7, Manuel Montero Pérez-Barquero8. 1. Geriatric Unit, Internal Medicine Service, IDIBELL, Hospital Universitari de Bellvitge, L´Hospitalet de Llobregat, Barcelona, Spain. Electronic address: fformiga@bellvitgehospital.cat. 2. Geriatric Unit, Internal Medicine Service, IDIBELL, Hospital Universitari de Bellvitge, L´Hospitalet de Llobregat, Barcelona, Spain. 3. Internal Medicine Department, Hospital Universitario de Gran Canaria Dr. Negrin, Universidad de Las Palmas de Gran Canaria, Spain. 4. Internal Medicine Department, Hospital Universitario Lozano Blesa, Zaragoza, Spain. 5. Internal Medicine Department, Hospital Universitario Central de Asturias, Oviedo, Spain. 6. Internal Medicine Department, Hospital Universitario Vall d´Hebrón, Barcelona, Spain. 7. Heart Failure and Vascular Risk Unit, Internal Medicine Department, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain. 8. Internal Medicine Department, IMBIC/Hospital Reina Sofía, Universidad de Córdoba, Spain.
Abstract
BACKGROUND: Many elderly heart failure (HF) patients show some degree of functional impairment. The study aim was to evaluate the functional status of oldest-old cohort of patients hospitalized with a diagnosis of decompensated (HF), and to analyze whether preadmission functional status predicts risk of 3-month mortality. METHODS: We analyzed 1431 elderly (≥ 75 years) patients prospectively included in the Spanish National Registry on HF (RICA). We added Barthel Index (BI) to the usual HF patient assessment to measure patients' functional status, and we evaluated the relationship between preadmission BI values and 3-month mortality. RESULTS: The mean age of patients was 82.3 (4.6) years. Patients' mean preadmission BI score was 81.3 (21.5); 802 patients (55.9%) had BI scores <61. Multivariate analysis confirmed an independent association between poor preadmission BI and older age, female sex, higher comorbidity, cognitive impairment, previous institutionalization, worse New York Heart Association (NYHA) functional class and lack of beta-blocker use. A total of 210 patients died (14.7%) after 3 months of follow-up. Cox multivariate analyses found that higher preadmission BI is correlated with reduced all-cause, 3-month postdischarge mortality [hazard ratio (HR) 0.981; CI95% 0.975-0.986, p<0.001]. Other variables independently associated with 3-month mortality were male sex, lower body mass index, lower systolic blood pressure, a diagnosis of diabetes and chronic kidney disease, worse NYHA class and not receiving treatment with beta-blockers. CONCLUSIONS: Severe functional disability is present among more than half of older patients admitted because of a HF decompensation. For this population, preadmission BI is a strong predictor of short-term mortality.
BACKGROUND: Many elderly heart failure (HF) patients show some degree of functional impairment. The study aim was to evaluate the functional status of oldest-old cohort of patients hospitalized with a diagnosis of decompensated (HF), and to analyze whether preadmission functional status predicts risk of 3-month mortality. METHODS: We analyzed 1431 elderly (≥ 75 years) patients prospectively included in the Spanish National Registry on HF (RICA). We added Barthel Index (BI) to the usual HF patient assessment to measure patients' functional status, and we evaluated the relationship between preadmission BI values and 3-month mortality. RESULTS: The mean age of patients was 82.3 (4.6) years. Patients' mean preadmission BI score was 81.3 (21.5); 802 patients (55.9%) had BI scores <61. Multivariate analysis confirmed an independent association between poor preadmission BI and older age, female sex, higher comorbidity, cognitive impairment, previous institutionalization, worse New York Heart Association (NYHA) functional class and lack of beta-blocker use. A total of 210 patients died (14.7%) after 3 months of follow-up. Cox multivariate analyses found that higher preadmission BI is correlated with reduced all-cause, 3-month postdischarge mortality [hazard ratio (HR) 0.981; CI95% 0.975-0.986, p<0.001]. Other variables independently associated with 3-month mortality were male sex, lower body mass index, lower systolic blood pressure, a diagnosis of diabetes and chronic kidney disease, worse NYHA class and not receiving treatment with beta-blockers. CONCLUSIONS: Severe functional disability is present among more than half of older patients admitted because of a HF decompensation. For this population, preadmission BI is a strong predictor of short-term mortality.
Authors: Rosa Antonio-Oriola; Ercole Vellone; Angela Durante; Maddalena De Maria; Marco Di Nitto; Vicente Gea-Caballero; Iván Santolalla-Arnedo; Michał Czapla; José Vicente Benavent-Cervera; Juan Luis Sánchez-González; Raúl Juárez-Vela Journal: J Pers Med Date: 2022-04-12
Authors: Marta Herrero-Torrus; Neus Badosa; Cristina Roqueta; Sonia Ruiz-Bustillo; Eduard Solé-González; Laia C Belarte-Tornero; Sandra Valdivielso-Moré; Olga Vázquez; Núria Farré Journal: J Clin Med Date: 2022-03-30 Impact factor: 4.241
Authors: Manuel Méndez-Bailon; Rosario Iguarán-Bermudez; Francesc Formiga-Pérez; José Carlos Arévalo Lorido; Iván Suárez-Pedreira; Jose Luis Morales-Rull; Ana Serrado-Iglesias; Pau Llacer-Iborra; Gabriela Ormaechea-Gorricho; Francisco Javier Carrasco-Sánchez; Jesús Casado-Cerrada; Emmanuel Andrès; Jesús Diez-Manglano; Noel Lorenzo-Villalba; Manuel Montero-Pérez-Barquero Journal: J Clin Med Date: 2022-03-28 Impact factor: 4.241