Variables asociadas a deterioro funcional al alta y a los 3 meses en ancianos hospitalizados por insuficiencia cardíaca

Abstract

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.