A not negligible proportion of elderly patients with STEMI fulfilled the frailty criteria. Frailty was independently associated with mortality. A very simple, feasible geriatric assessment by trained nurses can contribute to predict mortality.

Aims The assumption that improved self-care in the setting of heart failure (HF) care necessarily translates into improvements in long-term mortality and/or hospitalization is not well established. We aimed to study the association between self-care and long-term mortality and other major adverse HF events (MAHFE). Methods and results We conducted an observational, prospective, cohort study of 1123 consecutive patients with chronic HF. The primary endpoint was all-cause mortality. We used the European Heart Failure Self-care Behaviour Scale 9-item version (EHFSCBS-9) to measure global self-care (overall score) and three specific dimensions of self-care including autonomy-based adherence, consulting behaviour and provider-based adherence. After a mean follow-up of 3.3 years, all-cause death occurred in 487 patients (43%). In adjusted analysis, higher EHFScBS-9 scores (better self-care) at baseline were associated with lower risk of all-cause death [hazard ratio (HR) 0.993, 95% confidence interval (CI) (0.988–0.997), P-value = 0.002], cardiovascular (CV) death [HR 0.989, 95% CI (0.981–0.996), P-value = 0.003], HF hospitalization [HR 0.993, 95% CI (0.988–0.998), P-value = 0.005], and the combination of MAHFE [HR 0.995, 95% CI (0.991–0.999), P-value = 0.018]. Similarly, impaired global self-care [HR 1.589, 95% CI (1.201–2.127), P-value = 0.001], impaired autonomy-based adherence [HR 1.464, 95% CI (1.114–1.923), P-value = 0.006], and impaired consulting behaviour dimensions [HR 1.510, 95% CI (1.140–1.923), P-value = 0.006] were all associated with higher risk of all-cause mortality. Conclusion In this study, we have shown that worse self-care is an independent predictor of long-term mortality (both, all-cause and CV), HF hospitalization, and the combinations of these endpoints in patients with chronic HF. Important dimensions of self-care such as autonomy-based adherence and consulting behaviour also determine the risk of all these outcomes in the long term.

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BackgroundPatient empowerment is a key factor in improving health outcomes. ObjectiveTo evaluate the psychometric properties of the Spanish version of the questionnaire on Patient Empowerment in Long-Term Conditions (PELC) that evaluates the degree of empowerment of patients with chronic diseases. MethodsThree measurements were made (at baseline, 2 weeks and 12 weeks) of quality of life (QoL), self-care, self-efficacy and empowerment. Reliability was evaluated as internal consistency for the entire sample. Test-retest reproducibility was evaluated for patients who were stable from baseline to week 2 (n = 70). Validity was analysed (n = 124) as baseline correlations with QoL, self-care, self-efficacy, clinical data and psychosocial variables. Sensitivity to change was analysed in terms of effect size for patients who had improved between baseline and week 12 (n = 48).

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