[Morbidity from patients admitted for heart failure in the departments of internal medicine].
OBJECTIVE
Heart Failure (HF) patients present frequently comorbidities. Little is known about the impact of these comorbidities in morbimortality. We analyzed the comorbidities of HF patients admitted in Spanish internal medicine units and its relation with different socio-demographics and clinical variables.


METHODS
We studied prospectively 2127 patients (admitted from 01.10.2000-28.02.2001) with HF in 51 Hospitals of different categories (from local hospitals to university hospitals) in which an internist was available to collaborate in the study. Comorbidities were estimated by the Charlson index.


RESULTS
Mean age was 77 years (women 57%). 45% of patients have had a previous admission in the last year. 41% had a functional stage NYHA iii/iv. Eyection fraction was preserved in 53% of patients. Comorbidities were identified in 60% of patients (diabetes mellitus, 39%; chronic lung disease 31%). The average Charlson index was 5.4 points (range 2-11 points). Global inhospital mortality was 6.1%. During the admission more patients died in the Group with higher comorbidities (Charlson, >3 points; 8.4%) than in the Group with low Charlson index (1-2, 5.2%; p<0.01). Treatments prescribed were similar in both groups. In a multivariant analysis comorbidities was associated independently with masculine gender, age superior to 75 years, functional status NYHA iii/iv and dysfunctional physical capacity.


CONCLUSIONS
Comorbidities determined by Charlson index were associated with more frequent admission, longer stay in hospital, higher discapacity and higher mortality. These results enhance the importance of comorbidities in prognosis of heart failure patients admitted in internal medicine units in Spain.
Hospital Universitario Reina Sofía, Córdoba, España. mmontero@cica.es
M
M
Montero Pérez-Barquero
P
P
Conthe Gutiérrez
P
P
Román Sánchez
J
J
García Alegría
J
J
Forteza-Rey
D000368:Aged; D005260:Female; D006333:Heart Failure / Q000150:complications*; D006748:Hospital Departments; D006801:Humans; D007388:Internal Medicine; D008297:Male; D010343:Patient Admission; D011446:Prospective Studies; D012959:Socioeconomic Factors; D013030:Spain
Comorbilidad de los pacientes ingresados por insuficiencia cardiaca en los servicios de medicina interna.