ABSTRACT
Objetivo: Evaluar la utilidad de la escala de cribado de la fragilidad (Identification of Senior at Risk [ISAR]) para predecir la mortalidad a los 30 días en los pacientes mayores atendidos por insuficiencia cardiaca aguda (ICA) en los servicios de urgencias hospitalarios (SUH). Diseño: Estudio multicéntrico observacional de cohorte multipropósito. Ámbito: Registro OAK-3. Participantes: Pacientes ≥ 65 años atendidos por ICA en 16 SUH españoles de enero a febrero del 2016. Intervención: Ninguna. Variables: La variable de estudio fue la escala ISAR. La variable de resultado fue la mortalidad por cualquier causa a los 30 días. Resultados: Se incluyó a 1.059 pacientes (edad media 85±5,9 años). Ciento sesenta (15,1%) casos tuvieron 0-1 puntos, 278 (26,3%) 2 puntos, 260 (24,6%) 3 puntos, 209 (19,7%) 4 puntos y 152 (14,3%) 5-6 puntos de la escala ISAR. Noventa y cinco (9,0%) pacientes fallecieron a los 30 días. La frecuencia de mortalidad se incrementó en relación a la categoría del ISAR (p tendencia lineal <0,001). El área bajo la curva de la escala ISAR fue de 0,703 (intervalo de confianza del 95%, 0,655-0,751; p <0,001). Tras el ajuste por las categorías del modelo de riesgo EFFECT, hubo un incremento progresivo de la razón de ventajas de los grupos de la escala ISAR en comparación con el grupo de referencia (0-1 puntos). Conclusiones: La escala ISAR es una herramienta breve y sencilla que debería ser considerada para el despistaje de la fragilidad en la valoración inicial de los pacientes mayores con insuficiencia cardiaca aguda de cara a predecir la mortalidad a 30 días
Objective: To assess the value of frailty screening tool (Identification of Senior at Risk [ISAR]) in predicting 30-day mortality risk in older patients attended in emergency department (ED) for acute heart failure (AHF). Design: Observational multicenter cohort study. Setting: OAK-3 register. Subjects: Patients aged ≥65 years attended with ADHF in 16 Spanish EDs from January to February 2016. Intervention: No. Variables: Variable of study was ISAR scale. The outcome was all-cause 30-day mortality. Results: We included 1059 patients (mean age 85±5,9 years old). One hundred and sixty (15.1%) cases had 0-1 points, 278 (26.3%) 2 points, 260 (24.6%) 3 points, 209 (19.7%) 4 points, and 152 (14.3%) 5-6 points of ISAR scale. Ninety five (9.0%) patients died within 30 days. The percentage of mortality increased in relation to ISAR category (lineal trend P value <.001). The area under curve of ISAR scale was 0.703 (95%CI 0.655-0.751; P<.001). After adjusting for EFFECT risk categories, we observed a progressive increase in odds ratios of ISAR scale groups compared to reference (0-1 points). Conclusions: scale is a brief and easy tool that should be considered for frailty screening during initial assessment of older patients attended with AHF for predicting 30-day mortality
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Heart Failure/diagnosis , Heart Failure/mortality , Geriatric Assessment/methods , Frail Elderly , Predictive Value of Tests , Risk Assessment , Repertory, BarthelABSTRACT
OBJECTIVE: To assess the value of frailty screening tool (Identification of Senior at Risk [ISAR]) in predicting 30-day mortality risk in older patients attended in emergency department (ED) for acute heart failure (AHF). DESIGN: Observational multicenter cohort study. SETTING: OAK-3 register. SUBJECTS: Patients aged ≥65 years attended with ADHF in 16 Spanish EDs from January to February 2016. INTERVENTION: No. VARIABLES: Variable of study was ISAR scale. The outcome was all-cause 30-day mortality. RESULTS: We included 1059 patients (mean age 85±5,9 years old). One hundred and sixty (15.1%) cases had 0-1 points, 278 (26.3%) 2 points, 260 (24.6%) 3 points, 209 (19.7%) 4 points, and 152 (14.3%) 5-6 points of ISAR scale. Ninety five (9.0%) patients died within 30 days. The percentage of mortality increased in relation to ISAR category (lineal trend P value <.001). The area under curve of ISAR scale was 0.703 (95%CI 0.655-0.751; P<.001). After adjusting for EFFECT risk categories, we observed a progressive increase in odds ratios of ISAR scale groups compared to reference (0-1 points). CONCLUSIONS: scale is a brief and easy tool that should be considered for frailty screening during initial assessment of older patients attended with AHF for predicting 30-day mortality.
Subject(s)
Frailty/diagnosis , Heart Failure/mortality , Acute Disease , Aged , Aged, 80 and over , Area Under Curve , Emergency Service, Hospital , Female , Humans , Male , Odds Ratio , Regression Analysis , Risk Assessment/methods , Time FactorsABSTRACT
No disponible
Subject(s)
Humans , Emergency Service, Hospital/organization & administration , Ultrasonography/trends , Health Plan Implementation , Patient Care/trendsSubject(s)
Emergency Service, Hospital , Point-of-Care Systems , Hospitals, Public , Spain , UltrasonographyABSTRACT
No disponible
Subject(s)
Humans , Diabetes Mellitus/epidemiology , Diabetes Complications , Acute Coronary Syndrome/complications , Patient Education as Topic/methods , AwarenessABSTRACT
No disponible
Subject(s)
Humans , Male , Aged, 80 and over , Frail Elderly/statistics & numerical data , Heart Failure/complications , Heart Failure/epidemiology , Heart Failure/prevention & control , Health Services for the Aged , Comorbidity , Patient Readmission/statistics & numerical dataABSTRACT
No disponible
