The Effect of Frailty on 30-day Mortality Risk in Older Patients With Acute Heart Failure Attended in the Emergency Department


Por: Martin-Sanchez, FJ, Rodriguez-Adrada, E, Mueller, C, Vidan, MT, Christ, M, Peacock, WF, Rizzi, MA, Alquezar, A, Pinera, P, Aragues, PL, Llorens, P, Herrero, P, Jacob, J, Fernandez, C, Miro, O

Publicada: 1 mar 2017
Resumen:
ObjectiveThe objective was to determine the effect of frailty on risk of 30-day mortality in nonseverely disabled older patients with acute heart failure (AHF) attended in emergency departments (EDs). MethodologyThe Frailty-AHF Study is a retrospective analysis of a multicenter, observational, prospective, cohort study (Older-AHF Register). This study included consecutive patients 65 years of age without severe functional dependence or dementia attended for AHF in three Spanish EDs for 4 months. Frailty was defined by frailty phenotype as the presence of three or more domains. Baseline and episode characteristics and 30-day mortality were collected in all the patients. ResultsA total of 465 patients with a mean (SD) age of 82 (+/- 7) years were included, 283 (61.0%) being female and 225 (51.3%) with severe comorbidity (Charlson index 3). Frailty was present in 169 (36.3%). The rate of 30-day mortality was 7.3%. Frailty adjusted for potential confounding factors was an independent factor associated with 30-day mortality (adjusted hazard ratio=2.5; 95% confidence interval= 1.0 to 6.0; p=0.047). ConclusionThe presence of frailty is an independent risk factor of 30-day mortality in nonsevere dependent older patients attended with AHF in EDs.

Filiaciones:
Martin-Sanchez, FJ:
 Hosp Clin San Carlos IdISSC, Inst Invest Sanitaria, Emergency Dept, Hosp Clin San Carlos, Madrid, Spain

Rodriguez-Adrada, E:
 Hosp Clin San Carlos IdISSC, Inst Invest Sanitaria, Emergency Dept, Hosp Clin San Carlos, Madrid, Spain

Mueller, C:
 Univ Basel Hosp, Dept Cardiol, Basel, Switzerland

 Univ Basel Hosp, CRIB, Basel, Switzerland

Vidan, MT:
 Univ Complutense Madrid, Inst Invest IiSGM, Hosp Gen Univ Gregorio Maranon, Dept Geriatr Med, Madrid, Spain

Christ, M:
 Paracelsus Med Univ, Dept Emergency & Crit Care Med, Nurnberg, Germany

Peacock, WF:
 Baylor Coll Med, Dept Emergency Med, Houston, TX 77030 USA

Rizzi, MA:
 Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Emergency Dept, Barcelona, Spain

Alquezar, A:
 Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Emergency Dept, Barcelona, Spain

Pinera, P:
 Hosp Reina Sofia, Emergency Dept, Murcia, Spain

Aragues, PL:
 Hosp Reina Sofia, Emergency Dept, Murcia, Spain

Llorens, P:
 Univ Miguel Hernandez Alicante, Inst Invest Sanitaria & Biomed Alicante ISABIAL, Hosp Gen Alicante, Emergency Dept,Unit Stay & Hosp Home,Fdn FISABIO, Alicante, Spain

Herrero, P:
 Hosp Cent Asturias, Emergency Dept, Oviedo, Asturias, Spain

Jacob, J:
 Hosp Univ Bellvitge, Emergency Dept, Barcelona, Spain

Fernandez, C:
 Univ Complutense Madrid, Inst Invest Sanitaria, Hosp Clin San Carlos, Dept Prevent Med,Hosp Clin San Carlos IdISSC, Madrid, Spain

Miro, O:
 Hosp Clin Barcelona, Emergency Dept, Barcelona, Catalonia, Spain

 Inst Recerca Biomad August Pi & Sunyer IDIBAPS, Barcelona, Catalonia, Spain
ISSN: 10696563





ACADEMIC EMERGENCY MEDICINE
Editorial
WILEY, 111 RIVER ST, HOBOKEN 07030-5774, NJ USA, Estados Unidos America
Tipo de documento: Article
Volumen: 24 Número: 3
Páginas: 298-307
WOS Id: 000397559200003
ID de PubMed: 27797432
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