Short-term prognostic factors in elderly patients seen in emergency departments for acute heart failure.
OBJECTIVE
To investigate factors associated with short-term mortality in elderly patients seen in emergency departments for an episode of acute heart failure.


METHODS
A prospective, non-interventional, multicenter, cohort study was carried out in patients aged 65 years and older who were treated in the emergency department of one of eight tertiary hospitals in Spain. Twenty-eight independent variables that could influence mortality at 30 days were assessed. They covered epidemiological and clinical factors and daily functioning. Data were obtained by reviewing medical records or by interviewing the patient or a relative. Multivariate logistic regression analysis was performed.


RESULTS
The study included 623 patients, 42 of whom (6.7%) died within 30 days of visiting the emergency department. Four variables were significantly associated with higher mortality: functional dependence at baseline (i.e., Barthel index=60; odds ratio [OR]=2.9; 95% confidence interval [CI], 1.2-6.5), New York Heart Association class III-IV (OR=3; 95% CI, 1.3-7), systolic blood pressure <100 mmHg (OR=4.8; 95% CI, 1.6-14.5) and blood sodium <135 mEq/l (OR=4.2; 95% CI, 1.8-9.6).


CONCLUSIONS
Several factors evaluated on initial assessment in the emergency department, including the level of functional dependence, were found to determine a poor short-term prognosis in elderly patients who present with an episode of acute heart failure.
Miró
Oscar
O
Area de Urgencias, Hospital Clínic, Barcelona, España.
Llorens
Pere
P
Martín-Sánchez
Francisco Javier
FJ
Herrero
Pablo
P
Pavón
José
J
Pérez-Durá
M José
MJ
Bella Alvarez
Ana
A
Jacob
Javier
J
González
César
C
González-Armengol
Juan Jorge
JJ
Gil
Víctor
V
Alonso
Héctor
H
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital; D005260:Female; D006333:Heart Failure / Q000401:mortality*; D006801:Humans; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors