title: [Correlation between evolution of the cognitive function and mortality after hospital discharge in elderly patients with advanced heart failure].
abstract: OBJECTIVE
  To assess the relation between the evolution of cognitive performance and the prognosis of elderly patients after compensation of advanced heart failure.
  
  
  METHODS
  Thirty-one patients older than 64 (68 +/- 7) years and admitted with New York Heart Association class IV heart failure and ejection fraction = 0.45 (0.38 +/- 0.06) were consecutively selected. They underwent cognitive tests (digit span, digit symbol, letter cancellation, trail making A and B) and the 6-minute walking test 4 days before (T1) and 6 weeks after (T2) hospital discharge, and their performances were compared using the t test. The prognostic value of the scores of the cognitive tests was analyzed with logistic regression, and the value of greatest accuracy of the tests was associated with the prognosis determined by the ROC curve.
  
  
  RESULTS
  After 24.7 months, 17 (55%) patients had died. The performances in the 6-minute walking test and most cognitive tests improved between T1 and T2. The digit span score of the survivors ranged from 3.9 to 5.2 (P=0.003) and remained unaltered among those who died (4.1 to 3.9; P=0.496). An improvement < 0.75 points in the score was associated with mortality (relative risk of 8.1; P=0.011).
  
  
  CONCLUSIONS
  In the elderly, after compensation of advanced heart failure, the lack of evolutionary improvement in cognitive performance was associated with a worse prognosis.
authors.affiliation: Instituto do Coração, Hospital das Clínicas, FM, USP. mochiai@osite.com.br
authors.forename: Marcelo E
authors.initials: ME
authors.lastname: Ochiai
authors.forename: Luciano L S
authors.initials: LL
authors.lastname: Franco
authors.forename: Otávio C E
authors.initials: OC
authors.lastname: Gebara
authors.forename: Amit
authors.initials: A
authors.lastname: Nussbacher
authors.forename: João B
authors.initials: JB
authors.lastname: Serro-Azul
authors.forename: Humberto
authors.initials: H
authors.lastname: Pierri
authors.forename: Jairo
authors.initials: J
authors.lastname: Rays
authors.forename: Antonio C P
authors.initials: AC
authors.lastname: Barretto
authors.forename: Mauricio
authors.initials: M
authors.lastname: Wajngarten
mesh_terms: D000368:Aged; D001938:Brazil / Q000453:epidemiology; D003071:Cognition / Q000502:physiology*; D005260:Female; D006333:Heart Failure / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011379:Prognosis; D016019:Survival Analysis; D015996:Survival Rate; D016138:Walking / Q000502:physiology