[Risk factors associated with functional impairment at discharge and at three months after discharge in elderly individuals hospitalized for heart failure]. / Variables asociadas a deterioro funcional al alta y a los 3 meses en ancianos hospitalizados por insuficiencia cardíaca.

OBJECTIVE: To determine the characteristics of elderly persons hospitalized for congestive heart failure and identify the factors associated with functional impairment or death at discharge and 3 months later. MATERIAL AND METHODS: We performed a prospective observational study that included 162 patients admitted to an Acute Geriatric Care Unit with a diagnosis of heart failure from February to July 2007. Socio-demographic, clinical, functional and cognitive factors were recorded during admission. Functional and vital measurements were reported at discharge and 3 months later. RESULTS: The incidence of mortality or functional decline was 48.8% at discharge and was 37.3% 3 months later. In the final model, predictors of functional impairment or mortality at discharge were days of hospital stay and a worse Pfeiffer test score (odds ratio [OR]: 1.74; 95% confidence interval [CI]: 1.33-2.29). Three months after discharge, independent prognostic factors were age (OR: 1.09; 95% CI: 1.02-1.17), hyponatremia (OR: 0.85; 95% CI: 0.77-0.94), length of QRS in milliseconds (OR: 0.98; 95% CI: 0.97-0.99), absence of ventricular hypertrophy (OR: 0.42; 95% CI: 0.19-0.94), and a poor result in the Pfeiffer Test (OR: 1.40; 95% CI: 1.13-1.73). CONCLUSIONS: Cognitive evaluation during hospital admission for heart failure in the elderly helps to select individuals at risk of functional impairment or death at discharge and 3 months later.

Variables asociadas a deterioro funcional al alta y a los 3 meses en ancianos hospitalizados por insuficiencia cardíaca / Risk factors associated with functional impairment at discharge and at three months after discharge in elderly individuals hospitalized for heart failure

Objetivo: Describir las características de pacientes ancianos hospitalizados con un diagnóstico de insuficiencia cardíaca y establecer las variables asociadas con el desarrollo de deterioro funcional o defunción al alta y a los 3 meses. Materia y métodos: Estudio observacional y prospectivo en el que se incluyó a 162 pacientes con el diagnóstico de insuficiencia cardíaca que ingresaron en una unidad de agudos de geriatría entre febrero y julio de 2007. Durante la hospitalización se recogieron variables clínicas, sociodemográficas, funcionales y cognitivas, y al alta y a los 3 meses, datos sobre su estado funcional y vital. Resultados: La incidencia de mortalidad o deterioro funcional al alta y a los 3 meses fue del 48,8 y el 37,3%, respectivamente. En el modelo final permanecieron como predictores de deterioro funcional o defunción al alta los días de estancia hospitalaria y una peor puntuación en el cuestionario de Pfeiffer (odds ratio [OR]=1,74; intervalo de confianza [IC] del 95%, 1,33¿2,29). A los 3 meses las variables relacionadas fueron la edad (OR=1,09; IC del 95%, 1,02¿1,17), la hiponatremia (OR=0,85; IC del 95%, 0,77¿0,94), el tamaño del QRS en milisegundos (OR=0,98; IC del 95%, 0,97¿0,99), la ausencia de HVI (OR=0,42; IC del 95%, 0,19¿0,94) y la prueba de Pfeiffer alterada (OR=1,40; IC del 95%, 1,13¿1,73). Conclusiones: La valoración cognitiva durante la hospitalización de un anciano por insuficiencia cardíaca facilita la selección de individuos susceptibles de deterioro funcional o defunción al alta y a los 3 meses (AU)

Objective: To determine the characteristics of elderly persons hospitalized for congestive heart failure and identify the factors associated with functional impairment or death at discharge and 3 months later. Material and methods: We performed a prospective observational study that included 162 patients admitted to an Acute Geriatric Care Unit with a diagnosis of heart failure from February to July 2007. Socio-demographic, clinical, functional and cognitive factors were recorded during admission. Functional and vital measurements were reported at discharge and 3 months later. Results: The incidence of mortality or functional decline was 48.8% at discharge and was 37.3% 3 months later. In the final model, predictors of functional impairment or mortality at discharge were days of hospital stay and a worse Pfeiffer test score (odds ratio [OR]: 1.74; 95% confidence interval [CI]: 1.33¿2.29). Three months after discharge, independent prognostic factors were age (OR: 1.09; 95% CI: 1.02¿1.17), hyponatremia (OR: 0.85; 95% CI: 0.77¿0.94), length of QRS in milliseconds (OR: 0.98; 95% CI: 0.97¿0.99), absence of ventricular hypertrophy (OR: 0.42; 95% CI: 0.19¿0.94), and a poor result in the Pfeiffer Test (OR: 1.40; 95% CI: 1.13¿1.73). Conclusions: Cognitive evaluation during hospital admission for heart failure in the elderly helps to select individuals at risk of functional impairment or death at discharge and 3 months later (AU)