One-year mortality related factors in older-old patients admitted with heart failure in six Spanish hospitals

Abstract:Aims: We sought to investigate the prognostic impact of co-morbid burden as defined by the Charlson comorbidity index (CCI) in patients with a range of prevalent cardiovascular diseases. Methods & Results:We searched MEDLINE and EMBASE to identify studies that evaluated the impact of CCI on mortality in patients with cardiovascular disease. A random effects meta-analysis was undertaken to evaluate the impact of CCI on mortality in patients with coronary heart disease (CHD), heart failure (HF) and cerebrovascular accident (CVA).A total of 11 studies of acute coronary syndrome (ACS), 2 stable coronary disease, 5 percutaneous coronary intervention (PCI), 13 HF and 4 CVA met the inclusion criteria. An increase in CCI score per point was significantly associated with a greater risk of mortality in patients with ACS (pooled relative risk ratio (RR) 1.33 95%CI 1.15-1.54), PCI (RR 1.21 95% CI1.12-1.31) stable coronary artery disease (RR 1.38 95%CI 1.29-1.48) and HF (RR1.21 95%CI 1.13-1.29), but not CVA. A CCI score >2 significantly increased the risk of mortality in ACS (RR 2.52 95% CI 1.58-4.04), PCI (3.36 95%CI 2.14-5.29), HF (RR 1.76 95%CI 1.65-1.87) and CVA . Conclusion:Increasing co-morbid burden as defined by CCI is associated with a significant increase in risk of mortality in patients with underlying CHD, HF and CVA. CCI provides a simple way of predicting adverse outcomes in patients with CV disease and should be incorporated into decision-making processes when counseling patients.

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One-year mortality related factors in older-old patients admitted with heart failure in six Spanish hospitals

Cited by 2 publications

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Comorbidity assessment for mortality risk stratification in elderly patients with acute coronary syndrome

Comorbidity assessment for mortality risk stratification in elderly patients with acute coronary syndrome

Impact of co-morbid burden on mortality in patients with coronary heart disease, heart failure, and cerebrovascular accident: a systematic review and meta-analysis

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