Details

Autor(en) / Beteiligte

• Martín-Sánchez, Francisco Javier
• Rodríguez-Adrada, Esther
• Vidan, Maria Teresa
• Llopis García, Guillermo
• González del Castillo, Juan
• Rizzi, Miguel Alberto
• Alquezar, Aitor
• Piñera, Pascual
• Lázaro Aragues, Paula
• Llorens, Pere
• Herrero, Pablo
• Jacob, Javier
• Gil, Víctor
• Fernández, Cristina
• Bueno, Héctor
• Miró, Òscar
• Pérez-Durá, María José
• Gil, Pablo Berrocal
• Miró, Óscar
• Espinosa, Víctor Gil
• Sánchez, Carolina
• Aguiló, Sira
• Vall, Maria Àngels Pedragosa
• Aguirre, Alfons
• Aragues, Paula Lázaro
• Bordigoni, Miguel Alberto Rizzi
• Richard, Fernando
• Ferrer, Carles
• Llopis, Ferrán
• Sánchez, F. Javier Martín
• del Castillo, Juan González
• García, Guillermo Llopis
• Salgado, Lucía
• Mandly, Eduardo Anguita
• Ortega, Julián Sanz
• de los Ángeles Cuadrado Cenzual, María
• de Heredia, Maria Dolores Inés Ortega
• Soriano, Pere Llorens
• Fernández-Cañadas, José María
• Carratalá, José Manuel
• Javaloyes, Patricia
• Puente, Pablo Herrero
• García, Iván Rancaño
• Coya, María Fernández
• Fernández, José Antonio Sevillano
• Andueza, Juan
• Pareja, Rodofo Romero
• del Arco, Carmen
• Martín, Alfonso
• Torres, Raquel
• Miranda, Belén Rodríguez
• Martín, Vanesa Sendín
• Guillén, Carlos Bibiano
• Puig, Rodrigo Pacheco

Titel

Impact of Frailty and Disability on 30-Day Mortality in Older Patients With Acute Heart Failure

Ist Teil von

• The American journal of cardiology, 2017-10, Vol.120 (7), p.1151-1157

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2017

Quelle

MEDLINE

Beschreibungen/Notizen

• The objectives were to determine the impact of frailty and disability on 30-day mortality and whether the addition of these variables to HFRSS EFFECT risk score (FBI-EFFECT model) improves the short-term mortality predictive capacity of both HFRSS EFFECT and BI-EFFECT models in older patients with acute decompensated heart failure (ADHF) atended in the emergency department. We performed a retrospective analysis of OAK Registry including all consecutive patients ≥65 years old with ADHF attended in 3 Spanish emergency departments over 4 months. FBI-EFFECT model was developed by adjusting probabilities of HFRSS EFFECT risk categories according to the 6 groups (G1: non frail, no or mildly dependent; G2: frail, no or mildly dependent; G3: non frail, moderately dependent; G4: frail, moderately dependent; G5: severely dependent; G6: very severely dependent).We included 596 patients (mean age: 83 [SD7]; 61.2% females). The 30-day mortality was 11.6% with statistically significant differences in the 6 groups (p < 0.001). After adjusting for HFRSS EFFECT risk categories, we observed a progressive increase in hazard ratios from groups G2 to G6 compared with G1 (reference). FBI-EFFECT had a better prognostic accuracy than did HFRSS EFFECT (log-rank p < 0.001; Net Reclassification Improvement [NRI] = 0.355; p < 0.001; Integrated Discrimination Improvement [IDI] = 0.052; p ;< 0.001) and BI-EFFECT (log-rank p = 0.067; NRI = 0.210; p = 0.033; IDI = 0.017; p = 0.026). In conclusion, severe disability and frailty in patients with moderate disability are associated with 30-day mortality in ADHF, providing additional value to HFRSS EFFECT model in predicting short-term prognosis and establishing a care plan.