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Title: Basal functional status predicts one-year mortality after a heart failure hospitalization in elderly patients — The RICA prospective study
Authors: Chivite, David
Formiga, Francesc
Corbella, Xavier
Conde-Martel, Alicia 
Aramburu, Óscar
Carrera, Margarita
Dávila, Melitón Francisco
Pérez-Silvestre, José
Manzano, Luis
Montero-Pérez-Barquero, Manuel
UNESCO Clasification: 32 Ciencias médicas
320501 Cardiología
Keywords: Heart failure
Elderly patients
RICA prospective study
Issue Date: 2018
Journal: International Journal of Cardiology 
Abstract: Background: Dependence for basic activities of the daily living (ADL) relates to adverse outcomes in elderly acute heart failure (AHF) patients. Methods: We evaluated patients ≥75years admitted because of AHF, divided according to preadmission Barthel Index (BI) category: severe (BI 0-60), moderate (BI 61-90) and slight dependence or independence for basic ADL (BI 91-100). We compared their baseline characteristics and used logistic regression models to determine whether a BI≤60 confers higher one-year mortality risk. Results: We included 2195 patients, mean age 83years; 57% women, Charlson Index 3, 65% with preserved left ventricular ejection fraction. Their median preadmission BI was 90 (65-100); 21.7% had BI≤60. Patients with BI≤60 were older, more often females, with higher comorbid and cognitive burden and more likely to be institutionalized. 560 patients (26%) died within the follow-up period. A preadmission BI≤60 was significantly associated with higher risk of 12-month mortality (HR 1.42, 95% CI 1.14-1.77) together with male sex (1.27, 1.04-1.54), valve disease (1.49, 1.20-1.83), worse preadmission NYHA class (1.44, 1.20-1.73), stage IV chronic kidney disease (1.70, 1.35-2.15), pulmonary edema (1.33, 1.01-1.76), no family support (1.47, 1.06-2.06), and higher Charlson Comorbidity Index (1.09, CI 1.05-1.13) and Pfeiffer cognitive screening questionnaire scores (1.10, 1.05-1.14). Conclusion: Among elderly AHF patients, the presence of severe (BI≤60) preadmission dependence for basic ADL confers a significant and independent risk of one-year post-discharge mortality.
ISSN: 0167-5273
DOI: 10.1016/j.ijcard.2017.10.104
Source: International Journal of Cardiology[ISSN 0167-5273],v. 254, p. 182-188 (Marzo 2018)
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