Functional status and co-morbidities are associated with in-hospital mortality among older patients with acute decompensated heart failure: a multicentre prospective cohort study

Corvoisier, Philippe Le; Bastuji‐Garin, Sylvie; Renaud, Bertrand; Mahé, Isabelle; Bergmann, Jean‐François; Perchet, H; Paillaud, Éléna; Mottier, Dominique; Montagne, Olivier

doi:10.1093/ageing/afu144

Cited by 25 publications

(34 citation statements)

References 30 publications

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“…Renal function is one of the most powerful determinants of prognosis in AHF and is part of most risk scores for ADHF . Creatinine clearance has been proven to be an independent prognostic factor for in‐hospital mortality of older patients with ADHF . In patients with impaired renal function NT‐proBNP concentrations are raised and correlated to renal function; however, in our study both NT‐proBNP and eGFR entered into the final model and were independently correlated to prognosis.…”

Section: Discussionmentioning

confidence: 53%

Predictors of Long‐Term Mortality in Older Patients Hospitalized for Acutely Decompensated Heart Failure: Clinical Relevance of Natriuretic Peptides

Passantino¹,

Guida²,

Lagioia³

et al. 2016

J American Geriatrics Society

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Section: Discussionmentioning

confidence: 53%

Predictors of Long‐Term Mortality in Older Patients Hospitalized for Acutely Decompensated Heart Failure: Clinical Relevance of Natriuretic Peptides

Passantino¹,

Guida²,

Lagioia³

et al. 2016

J American Geriatrics Society

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“…The pooled HRs from 2 studies revealed a significant increase in LOS in the cohort with elevated cTn (OR: 1.05, 95% CI: 1.01‐1.10, P = 0.06, I 2 = 59.5.0%, n = 949). Six studies assessed in‐hospital mortality, and the meta‐analysis showed a significant increase in the risk of death with no significant heterogeneity (OR: 2.57, 95% CI: 2.27‐2.91, P = 0.744, I 2 = 0.0%, n = 69,524). Similarly, 4 clinical studies found detectable or elevated cTn as a predictor of worsened composite clinical outcomes of death and major cardiovascular events (OR: 1.33, 95% CI: 1.03‐1.71, P = 0.473, I 2 = 0.0%, n = 1,313).…”

Section: Resultsmentioning

confidence: 98%

Cardiac troponin in patients hospitalized with acute decompensated heart failure: A systematic review and meta‐analysis

Yousufuddin

Abdalrhim

Wang

et al. 2016

Journal of Hospital Medicine

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BACKGROUND Elevated cardiac troponin (cTn) is often observed in patients with acute decompensated heart failure (ADHF). We assessed the magnitude of association and quality of supporting evidence between cTn and clinically important outcomes in persons hospitalized for ADHF. METHODS We searched MEDLINE In‐Process & Other Non‐Indexed Citations, MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus from inception through February 28, 2015. The outcomes analyzed included hospital length of stay (LOS), readmissions, and mortality. Random effects meta‐analysis was used to combine outcomes across studies. RESULTS We included 26 clinical studies. A detectable or elevated cTn was associated with increased LOS (odds ratio [OR]: 1.05; 95% confidence interval [CI]: 1.01‐1.10), increased in‐hospital mortality (OR: 2.57; 95% CI: 2.27‐2.91), and a composite of mortality and major adverse events (OR: 1.33; 95% CI: 1.03‐1.71) during hospitalization. ADHF patients with a detectable or elevated cTn were at increased risk for mortality and composite of mortality and readmission over the short term (mortality OR: 2.11; 95% CI: 1.43‐3.12; composite OR: 2.81; 95% CI: 1.60‐4.92), intermediate term (mortality OR: 2.21; 95% CI: 1.46‐3.35; composite OR: 2.30; 95% CI: 1.78‐2.99), and long term (mortality OR: 3.69; 95% CI: 2.64‐5.18; composite OR: 3.49; 95% CI: 2.08‐5.84). The overall confidence in estimates was moderate. CONCLUSIONS Among ADHF patients, a detectable or elevated cTn identifies subjects at increased risk for adverse clinical outcomes during acute hospitalization and those at higher risk for postdischarge mortality and composite of readmission and mortality. Journal of Hospital Medicine 2016;11:446–454. 2016 Society of Hospital Medicine

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“…[46, 47] We have demonstrated previously that functional status mediates the relationship between poor quality of life and cardiac event-free survival in heart failure. [46] These two prognostic indicators of poor outcomes are easily assessed in the clinical setting and provide important targets for intervention.…”

Section: Discussionmentioning

confidence: 99%

Health Literacy Predicts Morbidity and Mortality in Rural Patients With Heart Failure

Moser

Robinson

Biddle

et al. 2015

Journal of Cardiac Failure

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Background Patients hospitalized with heart failure are often readmitted. Health literacy may play a substantial role in the high rate of readmissions. The purpose of this study was to examine the association of health literacy with the composite end point of heart failure readmission rates and all-cause mortality in patients with heart failure living in rural areas. Methods and Results Rural adults (n = 575), hospitalized for heart failure within the last 6 months completed the Short Test of Functional Health Literacy in Adults (STOFHLA) to measure health literacy and were followed for at least two years. The percent of patients with the end point of heart failure readmission or all-cause death was different (p=0.001) among the three STOFHLA score levels. Unadjusted analysis revealed that patients with inadequate or marginal health literacy were 1.94 (95% confidence intervals [CI] 1.43, 2.63; p < 0.001) times, and 1.91 (95% CI 1.36, 2.67; p < 0.001) times, respectively, more likely to experience the outcome. After adjustment for covariates, health literacy remained a predictor of outcomes. Of the other covariates, worse functional class, higher comorbidity burden and higher depression score predicted worse outcomes. Conclusion Inadequate or marginal health literacy is a risk factor for heart failure rehospitalization or all-cause mortality among rural heart failure patients. Clinical Trials Registration: ClinicalTrials.gov; NCT00415545; http://clinicaltrials.gov/ct2/show/NCT00415545?term=dracup&rank=3

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Functional status and co-morbidities are associated with in-hospital mortality among older patients with acute decompensated heart failure: a multicentre prospective cohort study

Abstract: Co-morbidities and functional impairments are associated with a worse short-term prognosis in patients aged ≥75 years admitted for ADHF. Assessing these parameters at admission may improve patient management.

Cited by 25 publications

References 30 publications

Predictors of Long‐Term Mortality in Older Patients Hospitalized for Acutely Decompensated Heart Failure: Clinical Relevance of Natriuretic Peptides

Predictors of Long‐Term Mortality in Older Patients Hospitalized for Acutely Decompensated Heart Failure: Clinical Relevance of Natriuretic Peptides

Cardiac troponin in patients hospitalized with acute decompensated heart failure: A systematic review and meta‐analysis

Health Literacy Predicts Morbidity and Mortality in Rural Patients With Heart Failure

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