• Emergencias · Jun 2018

    Multicenter Study Observational Study

    Impact of geriatric assessment variables on 30-day mortality among older patients with acute heart failure.

    • Francisco Javier Martín-Sánchez, Esther Rodríguez-Adrada, María Teresa Vidán, Pablo Díez Villanueva, Guillermo Llopis García, Juan González Del Castillo, Alberto Rizzi Miguel M Servicio de Urgencias, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, España., Aitor Alquézar, Sergio Herrera Mateo, Pascual Piñera, José Andrés Sánchez Nicolás, Paula Lázaro Aragues, Pere Llorens, Pablo Herrero, Javier Jacob, Víctor Gil, Cristina Fernández, Héctor Bueno, and Òscar Miró.
    • Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, España. Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Universidad Complutense, Madrid, España.
    • Emergencias. 2018 Jun 1; 30 (3): 149-155.

    ObjetiveTo study the impact of geriatric assessment variables on 30-day mortality among older patients with acute heart failure (AHF).MethodsRetrospective analysis of cases in the OAK Registry (Older Acute Heart Failure Key Data), a prospectively compiled database of consecutive patients aged 65 years or older treated for AHF in 3 Spanish emergency departments over a 4-month period (November-December 2011 and January-February 2014). The patients underwent a geriatric assessment adapted for emergency department use on weekdays between 8 AM and 10 PM. Demographic, clinical, laboratory, and geriatric assessment variables were recorded. The geriatric variables were concurrent diseases; polypharmacy; frailty; functional, social, and cognitive status at baseline; results of screening for confusional state, cognitive impairment, and depression; and nutritional status. The primary outcome was all-cause mortality at 30 days.ResultsWe included 565 patients with a mean (SD) age of 83 (7.1) years; 346 (61.6%) were women. Sixty-five (11.5%) died within 30 days. Independent factors associated with 30-day mortality were acute confusional state (adjusted odds ratio [aOR], 2.2; 95% CI, 1.0–4.8; P=.04), acute illness (aOR, 1.8; 95% CI, 0.9–3.4; P=.05), loss of appetite in the past 3 months (aOR, 1.8; 95% CI, 1.0–3.4; P=.04), frailty (aOR, 2.0, 95% CI, 1.0–4.1; P=.05), and severe disability (aOR, 4.4; 95% CI, 1.9–11.4; P=.01).ConclusionsCertain geriatric variables should be considered when assessing short-term risk in older patients with AHF.

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