• Manuel Méndez-Bailon, Noel Lorenzo-Villalba, Francisco Epelde-Gonzálo, Pau Llàcer, Alicia Conde-Martel, Luis Manzano-Espinosa, José Carlos Arévalo-Lorido, Joan Carles Trullás, Jesús Casado-Cerrada, and Manuel Montero-Pérez-Barquero.
• Internal Medicine, University Hospital Clinico San Carlos, Facultad de Medicina, Universidad Complutense, IdISSC, Madrid, Spain.
• Med Clin (Barc). 2024 Feb 23; 162 (4): 157162157-162.

BackgroundPatients with chronic diseases such as heart failure (HF) are at risk of hospital admission. We evaluated the impact of living in nursing homes (NH) on readmissions and all-cause mortality of HF patients during a one-year follow up.MethodsAn observational and multicenter study from the Spanish National Registry of Heart Failure (RICA) was performed. We compared clinical and prognostic characteristics between both groups. Bivariate analyses were performed using Student's t-test and Tukey's method and a Kaplan-Meier survival at one-year follow up. A multivariate proportional hazards analysis of [Cox] regression by the conditional backward method was conducted for the variables being statistically significant related to the probability of death in the univariate.ResultsThere were 5644 patients included, 462 (8.2%) of whom were nursing home residents. There were 52.7% women and mean age was 79.7±8.8 years. NH residents had lower Barthel (74.07), Charlson (3.27), and Pfeiffer index (2.2), p<0.001). Mean pro-BNP was 6686pg/ml without statistical significance differences between groups. After 1-year follow-up, crude analysis showed no differences in readmissions 74.7% vs. 72.3%, p=0.292, or mortality 63.9% vs. 61.1%, p=0.239 between groups. However, after controlling for confounding variables, NH residents had a higher 1-year all-cause mortality (HR 1.153; 95% CI 1.011-1.317; p=0.034). Kaplan-Meier analysis showed worse survival in nursing home residents (log-rank of 7.12, p=0.008).ConclusionsNursing home residents with heart failure showed higher one-year mortality which could be due to worse functional status, higher comorbidity, and cognitive deterioration.Copyright © 2023 Elsevier España, S.L.U. All rights reserved.

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