Francisco Javier Martín-Sánchez1, Esther Rodríguez-Adrada1, Christian Mueller2, María Teresa Vidán3, Michael Christ4, W Frank Peacock5, Miguel Alberto Rizzi6, Aitor Alquezar6, Pascual Piñera7, Paula Lázaro Aragues7, Pere Llorens8, Pablo Herrero9, Javier Jacob10, Cristina Fernández11, Òscar Miró12. 1. Emergency Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain. 2. Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland. 3. Department of Geriatric Medicine, Hospital General Universitario Gregorio Marañón, Instituto de Investigación IiSGM, Universidad Complutense de Madrid, Madrid, Spain. 4. Department of Emergency and Critical Care Medicine, Paracelsus Medical University, Nürnberg, Germany. 5. Department of Emergency Medicine, Baylor College of Medicine, Houston, TX. 6. Emergency Department, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain. 7. Emergency Department, Hospital Reina Sofia, Murcia, Spain. 8. Emergency Department, Short Unit Stay and Hospital at Home, Hospital General de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-Fundación FISABIO), Universidad Miguel Hernández Alicante, Alicante, Spain. 9. Emergency Department, Hospital Central de Asturias, Oviedo, Asturias, Spain. 10. Emergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain. 11. Department of Preventive Medicine, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, Spain. 12. Emergency Department, Hospital Clínic, and Institut de Recerca Biomàdica August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.
Abstract
OBJECTIVE: The objective was to determine the effect of frailty on risk of 30-day mortality in nonseverely disabled older patients with acute heart failure (AHF) attended in emergency departments (EDs). METHODOLOGY: The Frailty-AHF Study is a retrospective analysis of a multicenter, observational, prospective, cohort study (Older-AHF Register). This study included consecutive patients ≥ 65 years of age without severe functional dependence or dementia attended for AHF in three Spanish EDs for 4 months. Frailty was defined by frailty phenotype as the presence of three or more domains. Baseline and episode characteristics and 30-day mortality were collected in all the patients. RESULTS: A total of 465 patients with a mean (±SD) age of 82 (±7) years were included, 283 (61.0%) being female and 225 (51.3%) with severe comorbidity (Charlson index ≥ 3). Frailty was present in 169 (36.3%). The rate of 30-day mortality was 7.3%. Frailty adjusted for potential confounding factors was an independent factor associated with 30-day mortality (adjusted hazard ratio = 2.5; 95% confidence interval = 1.0 to 6.0; p = 0.047). CONCLUSION: The presence of frailty is an independent risk factor of 30-day mortality in nonsevere dependent older patients attended with AHF in EDs.
OBJECTIVE: The objective was to determine the effect of frailty on risk of 30-day mortality in nonseverely disabled older patients with acute heart failure (AHF) attended in emergency departments (EDs). METHODOLOGY: The Frailty-AHF Study is a retrospective analysis of a multicenter, observational, prospective, cohort study (Older-AHF Register). This study included consecutive patients ≥ 65 years of age without severe functional dependence or dementia attended for AHF in three Spanish EDs for 4 months. Frailty was defined by frailty phenotype as the presence of three or more domains. Baseline and episode characteristics and 30-day mortality were collected in all the patients. RESULTS: A total of 465 patients with a mean (±SD) age of 82 (±7) years were included, 283 (61.0%) being female and 225 (51.3%) with severe comorbidity (Charlson index ≥ 3). Frailty was present in 169 (36.3%). The rate of 30-day mortality was 7.3%. Frailty adjusted for potential confounding factors was an independent factor associated with 30-day mortality (adjusted hazard ratio = 2.5; 95% confidence interval = 1.0 to 6.0; p = 0.047). CONCLUSION: The presence of frailty is an independent risk factor of 30-day mortality in nonsevere dependent older patients attended with AHF in EDs.
Authors: Mary Roberts Davis; Christopher S Lee; Amy Corcoran; Nandita Gupta; Izabella Uchmanowicz; Quin E Denfeld Journal: Int J Cardiol Date: 2021-02-28 Impact factor: 4.039
Authors: Ralph K L So; Jonathan Bannard-Smith; Chris P Subbe; Daryl A Jones; Joost van Rosmalen; Geoffrey K Lighthall Journal: Crit Care Date: 2018-09-22 Impact factor: 9.097
Authors: Izabella Uchmanowicz; Christopher S Lee; Cristiana Vitale; Stanisław Manulik; Quin E Denfeld; Bartosz Uchmanowicz; Joanna Rosińczuk; Marcin Drozd; Joanna Jaroch; Ewa A Jankowska Journal: ESC Heart Fail Date: 2020-09-21