Article: Predictors of 1-year outcome in very old patients managed in a Heart Failure Unit after an acute decompensation.
2022 Volume 13, Issue 6, Page(s) 1417–1424
Abstract: Purpose: Consensus exits about the clinical benefits of an early referral to multidisciplinary Heart Failure Unit-HFU for old frail patients with HF. Nevertheless, few data are present regarding the prognosis and the predictors of outcome in oldest-old ... ...
| Abstract | Purpose: Consensus exits about the clinical benefits of an early referral to multidisciplinary Heart Failure Unit-HFU for old frail patients with HF. Nevertheless, few data are present regarding the prognosis and the predictors of outcome in oldest-old patients managed in this clinical setting. The aim of present study is to identify predictors of 1-year all-cause mortality in very old patients enrolled in our multidisciplinary HFU after an episode of acute decompensated HF. Methods: This study is a retro-prospective, single-center cohort analysis of patients managed in our multidisciplinary HFU. Inclusion criterion was diagnosis of HF according to ESC guidelines and age ≥ 85 years, while no exclusion criteria were pre-defined. Baseline clinical and comprehensive geriatric evaluations were recorded during the first visit and follow-up visits were repeated according to our standardized timetable protocol. Primary end-point was 1-year all-cause mortality. Results: We enrolled 75 patients aged 89.2 ± 2.8 years; 39 (52.0%) were females. During 1-year follow-up, seventeen patients (22.7%) died. Residual congestion with higher level (> 4) of EVEREST score (HR 1.24: 95% CI 1.04-1.47) and living alone (HR 3.34: 95% CI 1.16-9.64) resulted the two independent predictors of 1-year all-cause mortality at the multivariate Cox regression model. Finally, patients living alone and with an EVEREST score > 4 experienced a worse prognosis as clearly described by a steeper descendent Kaplan-Meier curve. Conclusion: In a very old population of patients after an acute decompensated HF, residual congestion and social isolation as living alone identify those with high risk of 1-year death. |
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| Language | English |
| Publishing date | 2022-10-13 |
| Publishing country | Switzerland |
| Document type | Journal Article |
| ZDB-ID | 2556794-9 |
| ISSN | 1878-7657 ; 1878-7649 |
| ISSN (online) | 1878-7657 |
| ISSN | 1878-7649 |
| DOI | 10.1007/s41999-022-00679-5 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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