Comprehensive geriatric assessment and 2-year mortality in elderly patients hospitalized for heart failure

Rodriguez-Pascual, C., Paredes-Galan, E., Vilches-Moraga, A. , Ferrero-Martinez, A. I., Torrente-Carballido, M., Rodriguez-Artalejo, F. and , (2014) Comprehensive geriatric assessment and 2-year mortality in elderly patients hospitalized for heart failure. Circulation: Cardiovascular Quality and Outcomes, 7 (2). pp. 251-258. ISSN 1941-7713

Full content URL: http://dx.doi.org/10.1161/CIRCOUTCOMES.113.000551

Documents
2/251.full.pdf

Request a copy
[img] PDF
2/251.full.pdf - Whole Document
Restricted to Repository staff only

610kB
Item Type:Article
Item Status:Live Archive

Abstract

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.

Keywords:Frail elderly, geriatric assessment, Heart failure, mortality, JCOpen
Subjects:A Medicine and Dentistry > A300 Clinical Medicine
Divisions:College of Science > School of Pharmacy
ID Code:27770
Deposited On:29 Jun 2017 20:22

Repository Staff Only: item control page