Please use this identifier to cite or link to this item: http://hdl.handle.net/10553/51013
Title: Basal functional status predicts three-month mortality after a heart failure hospitalization in elderly patients - The prospective RICA study
Authors: Formiga, Francesc
Chivite, David
Conde, Alicia 
Ruiz-Laiglesia, Fernando
Franco, Álvaro González
Bocanegra, Carmen Pérez
Manzano, Luis
Pérez-Barquero, Manuel Montero
Keywords: Older Patients
Scoring System
Barthel Index
Admission
Outcomes, et al
Issue Date: 2014
Publisher: 0167-5273
Journal: International Journal of Cardiology 
Abstract: Background: Many elderly heart failure (HF) patients show some degree of functional impairment. The study aim was to evaluate the functional status of oldest-old cohort of patients hospitalized with a diagnosis of decompensated (HF), and to analyze whether preadmission functional status predicts risk of 3-month mortality.Methods: We analyzed 1431 elderly (>= 75 years) patients prospectively included in the Spanish National Registry on HF (RICA). We added Barthel Index (BI) to the usual HF patient assessment to measure patients' functional status, and we evaluated the relationship between preadmission BI values and 3-month mortality.Results: The mean age of patients was 82.3 (4.6) years. Patients' mean preadmission BI score was 81.3 (21.5); 802 patients (55.9%) had BI scores <61. Multivariate analysis confirmed an independent association between poor preadmission BI and older age, female sex, higher comorbidity, cognitive impairment, previous institutionalization, worse New York Heart Association (NYHA) functional class and lack of beta-blocker use. A total of 210 patients died (14.7%) after 3 months of follow-up. Cox multivariate analyses found that higher preadmission BI is correlated with reduced all-cause, 3-month postdischarge mortality [hazard ratio (HR) 0.981; CI95% 0.975-0.986, p < 0.001]. Other variables independently associated with 3-month mortality were male sex, lower body mass index, lower systolic blood pressure, a diagnosis of diabetes and chronic kidney disease, worse NYHA class and not receiving treatment with beta-blockers.Conclusions: Severe functional disability is present among more than half of older patients admitted because of a HF decompensation. For this population, preadmission BI is a strong predictor of short-term mortality. (C) 2014 Elsevier Ireland Ltd. All rights reserved.
URI: http://hdl.handle.net/10553/51013
ISSN: 0167-5273
DOI: 10.1016/j.ijcard.2013.12.169
Source: International Journal of Cardiology[ISSN 0167-5273],v. 172, p. 127-131
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