2026-04-29T07:25:37Zhttps://repisalud.isciii.es/rest/oai/request

oai:repisalud.isciii.es:20.500.12105/113032024-09-27T09:34:37Zcom_20.500.12105_19604com_20.500.12105_2051col_20.500.12105_19605

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.