BACKGROUND: In older adults hospitalized for heart failure, a poor score on a comprehensive geriatric assessment (CGA) is associated with worse prognosis during hospitalization and at 1 month after discharge. However, the association between the CGA score and long-term mortality is uncertain. METHODS AND RESULTS: This is a prospective study of 487 patients aged ≥75 years admitted for decompensated heart failure. At discharge, a CGA score (range, 0-10) was calculated based on limitation in activities of daily living, mobility limitation, comorbidity, cognitive decline, and previous medication use. The analysis of the association between the CGA score and 2-year subsequent mortality was performed with Cox regression and adjusted for the main confounders. A 1-point increase in the CGA score was associated with a 19% higher mortality (hazard ratio, 1.19; 95% confidence interval, 1.11-1.27). Results were similar regardless of age, sex, left ventricular ejection fraction, and the coexistence of atrial fibrillation, ischemic heart disease, or hypertensive cardiopathy. All components of the CGA score showed a consistent association with higher death risk: the hazard ratio (95% confidence interval) of mortality was 1.78 (1.25-2.54) with ≥3 versus 0 limitations in activities of daily living, 1.36 (1.0-1.86) with moderate or severe versus no or mild limitation in mobility, 1.98 (1.29-3.03) with a ≥5 versus ≤1 score on the Charlson index, 2.48 (1.84-3.34) with previous cognitive decline, and 1.77 (0.99-3.18) in those using ≥8 versus ≤3 medications. CONCLUSIONS: The score on a simple CGA is associated with long-term mortality in older patients hospitalized for heart failure.
BACKGROUND: In older adults hospitalized for heart failure, a poor score on a comprehensive geriatric assessment (CGA) is associated with worse prognosis during hospitalization and at 1 month after discharge. However, the association between the CGA score and long-term mortality is uncertain. METHODS AND RESULTS: This is a prospective study of 487 patients aged ≥75 years admitted for decompensated heart failure. At discharge, a CGA score (range, 0-10) was calculated based on limitation in activities of daily living, mobility limitation, comorbidity, cognitive decline, and previous medication use. The analysis of the association between the CGA score and 2-year subsequent mortality was performed with Cox regression and adjusted for the main confounders. A 1-point increase in the CGA score was associated with a 19% higher mortality (hazard ratio, 1.19; 95% confidence interval, 1.11-1.27). Results were similar regardless of age, sex, left ventricular ejection fraction, and the coexistence of atrial fibrillation, ischemic heart disease, or hypertensive cardiopathy. All components of the CGA score showed a consistent association with higher death risk: the hazard ratio (95% confidence interval) of mortality was 1.78 (1.25-2.54) with ≥3 versus 0 limitations in activities of daily living, 1.36 (1.0-1.86) with moderate or severe versus no or mild limitation in mobility, 1.98 (1.29-3.03) with a ≥5 versus ≤1 score on the Charlson index, 2.48 (1.84-3.34) with previous cognitive decline, and 1.77 (0.99-3.18) in those using ≥8 versus ≤3 medications. CONCLUSIONS: The score on a simple CGA is associated with long-term mortality in older patients hospitalized for heart failure.
Authors: A Vilches-Moraga; J Fox; A Paracha; A Gomez-Quintanilla; J Epstein; L Pearce Journal: Ann R Coll Surg Engl Date: 2018-06-18 Impact factor: 1.891
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: Thiago J Avelino-Silva; Jose M Farfel; Jose A E Curiati; Jose R G Amaral; Flavia Campora; Wilson Jacob-Filho Journal: BMC Geriatr Date: 2014-12-03 Impact factor: 3.921