Short-term mortality in end-stage heart failure patients
Verdú-Rotellar, Jose Maria (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Calero, Esther (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Abellana, Rosa (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Verdú-Soriano, José (Universitat d'Alacant)
Vinyoles, Ernest (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Del Val García, José Luis
Domingo, Mar (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Muñoz, Miguel-Angel (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Universitat Autònoma de Barcelona

Date:	2020
Abstract:	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). Patients attended at any of the 279 primary health care centers belonging to the Institut Català de la Salut, in Catalonia (Spain). Patients with Advanced HF. Multicenter cohort study including 1148 HF patients followed for one-year after reaching New York Heart Association (NYHA) IV. The primary outcome was all-cause mortality. Multivariate logistic regression models were performed to assess the outcomes at 1, 3, 6, and 12 months. 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 20 kg/m 2 (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). 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.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Heart failure ; End of life ; Epidemiology ; Prognostic factors ; Insuficiencia cardíaca ; Fin de vida ; Epidemiología ; Factores pronósticos
Published in:	Atencion Primaria, Vol. 52 (january 2020) , p. 477-487, ISSN 1578-1275

DOI: 10.1016/j.aprim.2019.07.019
PMID: 31932015

11 p, 991.3 KB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles