2024-03-29T08:39:19Zhttp://repisalud.isciii.es/oai/requestoai:repisalud.isciii.es:20.500.12105/113032022-11-08T10:00:56Zcom_20.500.12105_2145com_20.500.12105_2051com_20.500.12105_2144col_20.500.12105_2146
00925njm 22002777a 4500
dc
Martín-Sánchez, Francisco Javier
author
Rodríguez-Adrada, Esther
author
Vidan, Maria Teresa
author
Llopis García, Guillermo
author
González Del Castillo, Juan
author
Rizzi, Miguel Alberto
author
Alquezar, Aitor
author
Piñera, Pascual
author
Lázaro Aragues, Paula
author
Llorens, Pere
author
Herrero, Pablo
author
Jacob, Javier
author
Gil, Víctor
author
Fernández, Cristina
author
Bueno, Hector
author
Miró, Òscar
author
2017-10-01
The objectives were to determine the impact of frailty and disability on 30-day mortality and whether the addition of these variables to HFRSS EFFECT risk score (FBI-EFFECT model) improves the short-term mortality predictive capacity of both HFRSS EFFECT and BI-EFFECT models in older patients with acute decompensated heart failure (ADHF) atended in the emergency department. We performed a retrospective analysis of OAK Registry including all consecutive patients ≥65 years old with ADHF attended in 3 Spanish emergency departments over 4 months. FBI-EFFECT model was developed by adjusting probabilities of HFRSS EFFECT risk categories according to the 6 groups (G1: non frail, no or mildly dependent; G2: frail, no or mildly dependent; G3: non frail, moderately dependent; G4: frail, moderately dependent; G5: severely dependent; G6: very severely dependent).We included 596 patients (mean age: 83 [SD7]; 61.2% females). The 30-day mortality was 11.6% with statistically significant differences in the 6 groups (p < 0.001). After adjusting for HFRSS EFFECT risk categories, we observed a progressive increase in hazard ratios from groups G2 to G6 compared with G1 (reference). FBI-EFFECT had a better prognostic accuracy than did HFRSS EFFECT (log-rank p < 0.001; Net Reclassification Improvement [NRI] = 0.355; p < 0.001; Integrated Discrimination Improvement [IDI] = 0.052; p ;< 0.001) and BI-EFFECT (log-rank p = 0.067; NRI = 0.210; p = 0.033; IDI = 0.017; p = 0.026). In conclusion, severe disability and frailty in patients with moderate disability are associated with 30-day mortality in ADHF, providing additional value to HFRSS EFFECT model in predicting short-term prognosis and establishing a care plan.
Am J Cardiol. 2017; 120(7):1151-1157
0002-9149
http://hdl.handle.net/20.500.12105/11303
28826899
10.1016/j.amjcard.2017.06.059
The American journal of cardiology
Impact of Frailty and Disability on 30-Day Mortality in Older Patients With Acute Heart Failure.