Impact of comprehensive geriatric assessment on treatment outcomes of chronic heart failure in elderly patients complicated with emotional disorders / 中华老年医学杂志

ABSTRACT

Objective@#To investigate the impact of comprehensive geriatric assessment(CGA)on treatment outcomes of chronic heart failure(CHF)complicated with emotional disorders in the elderly.@*Methods@#A total of 216 CHF patients with emotional disorders at Henan Provincial People’s Hospital were recruited from September 2017 to March 2019 and were randomly divided into a CGA group and a control group with 108 cases in each group.The control group was given standard drug treatment and psychological counseling, whereas individualized treatment was given to participants in the CGA group in compliance with CGA guidelines.The clinical effects after intervention for 8 weeks in the two groups were examined, using measures such as Hamilton Depression Rating Scale for Depression(HAMD)-24, Hamilton Anxiety Scale(HAMA)-14, amino-terminal pro-brain natriuretic peptide(NT-proBNP), the 6 minute walk test(6MWT)and left ventricular ejection fraction(LVEF). The changes of cognitive status, nutritional status, fall risk and other indicators in patients were comprehensively assessed and statistically analyzed.@*Results@#Compared with pre-treatment data, 8 weeks of treatment for both the control group and the CGA group resulted in decreased HAMD-24 scores(Control group 31.78±9.08, 23.69±10.16; CGA group 32.09±8.98, 15.35±7.91; P<0.05), HAMA-14 scores(Control group 22.38±7.09, 15.28±6.54; CGA group 21.99±8.12, 10.48±6.82; P<0.05)and NT-proBNP levels[Control group (4672±392)ng/L, (3279±282)ng/L; CGA group (4861±378)ng/L, (2387±215)ng/L; P<0.05], and increased LVEF(%)[Control group(34.5±6.2)%, (39.8±7.5)%; CGA group(35.1±3.9)%, (42.5±6.1)%; P<0.05]and 6MWT scores[Control group(298±79±7.5)m, (358±102)m; CGA group(305±98)m, (402±178)m; P<0.05], with more marked changes in all the measures in the CGA group than in the control group(P<0.05).@*Conclusions@#The early application of CGA can improve the condition and prognosis in elderly heart failure patients complicated with emotional disorders.