Short-term mortality in end-stage heart failure patients
Copyright © 2019 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved..
OBJECTIVES: This study is aimed at analyzing the impact of the main factors contributing to short and long-term mortality in patients at final stages of heart failure (HF).
SETTING: Patients attended at any of the 279 primary health care centers belonging to the Institut Català de la Salut, in Catalonia (Spain).
PARTICIPANTS: Patients with Advanced HF.
DESIGN: Multicenter cohort study including 1148 HF patients followed for one-year after reaching New York Heart Association (NYHA) IV.
MAIN MEASUREMENTS: The primary outcome was all-cause mortality. Multivariate logistic regression models were performed to assess the outcomes at 1, 3, 6, and 12 months.
RESULTS: Mean age of patients was 82 (SD 9) years and women represented 61.7%. A total of 135 (11.8%) and 397 (34.6%) patients died three months and one year after inclusion, respectively. Male gender, age, and decreased body mass index were associated with higher mortality at three, six and twelve months. In addition, low systolic blood pressure levels, severe reduction in glomerular filtration, malignancy, and higher doses of loop diuretics were related to higher mortality from 6 to 12 months. The most important risk factor over the whole period was presenting a body mass index lower than 20kg/m2 (three months OR 3.06, 95% CI: 1.58-5.92; six months OR 4.42, 95% CI: 2.08-9.38; and 12 months OR 3.68, 95% CI: 1.76-7.69).
CONCLUSIONS: We may conclude that male, age, and decreased body mass index determined higher short-term mortality in NYHA IV. In addition, low systolic blood pressure, reduced glomerular filtration, malignancy, and higher doses of loop diuretics contribute to increasing the risk of mortality at medium and long-term. Such variables are easily measurable and can help to decide the best way to face the most advances stages of the disease.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:52 |
|---|---|
| Enthalten in: |
Atencion primaria - 52(2020), 7 vom: 23. Aug., Seite 477-487 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Verdú-Rotellar, Jose Maria [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 21.09.2021 Date Revised 21.09.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.aprim.2019.07.019 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM305306464 |
|---|
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| 100 | 1 | |a Verdú-Rotellar, Jose Maria |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Short-term mortality in end-stage heart failure patients |
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| 500 | |a Date Completed 21.09.2021 | ||
| 500 | |a Date Revised 21.09.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2019 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved. | ||
| 520 | |a OBJECTIVES: This study is aimed at analyzing the impact of the main factors contributing to short and long-term mortality in patients at final stages of heart failure (HF) | ||
| 520 | |a SETTING: Patients attended at any of the 279 primary health care centers belonging to the Institut Català de la Salut, in Catalonia (Spain) | ||
| 520 | |a PARTICIPANTS: Patients with Advanced HF | ||
| 520 | |a DESIGN: Multicenter cohort study including 1148 HF patients followed for one-year after reaching New York Heart Association (NYHA) IV | ||
| 520 | |a MAIN MEASUREMENTS: The primary outcome was all-cause mortality. Multivariate logistic regression models were performed to assess the outcomes at 1, 3, 6, and 12 months | ||
| 520 | |a RESULTS: Mean age of patients was 82 (SD 9) years and women represented 61.7%. A total of 135 (11.8%) and 397 (34.6%) patients died three months and one year after inclusion, respectively. Male gender, age, and decreased body mass index were associated with higher mortality at three, six and twelve months. In addition, low systolic blood pressure levels, severe reduction in glomerular filtration, malignancy, and higher doses of loop diuretics were related to higher mortality from 6 to 12 months. The most important risk factor over the whole period was presenting a body mass index lower than 20kg/m2 (three months OR 3.06, 95% CI: 1.58-5.92; six months OR 4.42, 95% CI: 2.08-9.38; and 12 months OR 3.68, 95% CI: 1.76-7.69) | ||
| 520 | |a CONCLUSIONS: We may conclude that male, age, and decreased body mass index determined higher short-term mortality in NYHA IV. In addition, low systolic blood pressure, reduced glomerular filtration, malignancy, and higher doses of loop diuretics contribute to increasing the risk of mortality at medium and long-term. Such variables are easily measurable and can help to decide the best way to face the most advances stages of the disease | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a End of life | |
| 650 | 4 | |a Epidemiology | |
| 650 | 4 | |a Epidemiología | |
| 650 | 4 | |a Factores pronósticos | |
| 650 | 4 | |a Fin de vida | |
| 650 | 4 | |a Heart failure | |
| 650 | 4 | |a Insuficiencia cardíaca | |
| 650 | 4 | |a Prognostic factors | |
| 650 | 7 | |a Angiotensin Receptor Antagonists |2 NLM | |
| 650 | 7 | |a Angiotensin-Converting Enzyme Inhibitors |2 NLM | |
| 700 | 1 | |a Calero, Esther |e verfasserin |4 aut | |
| 700 | 1 | |a Abellana, Rosa |e verfasserin |4 aut | |
| 700 | 1 | |a Verdú-Soriano, José |e verfasserin |4 aut | |
| 700 | 1 | |a Vinyoles, Ernest |e verfasserin |4 aut | |
| 700 | 1 | |a Del Val-García, José Luis |e verfasserin |4 aut | |
| 700 | 1 | |a Domingo, Mar |e verfasserin |4 aut | |
| 700 | 1 | |a Muñoz, Miguel-Angel |e verfasserin |4 aut | |
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