title: Prevalence of geriatric syndromes and impact on clinical and functional outcomes in older patients with acute cardiac diseases.
abstract: OBJECTIVE
  To assess the prevalence of major geriatric syndromes (MGSs)-frailty, cognitive impairment, severe dependence and depression-and their influence on outcomes in unselected patients with acute cardiac diseases.
  
  
  METHODS
  Observational prospective study with 12-month clinical and functional follow-up.
  
  
  METHODS
  Clinical cardiology unit of a university hospital in Madrid, Spain.
  
  
  METHODS
  Consecutive patients ≥75 years old urgently admitted to the cardiology unit.
  
  
  METHODS
  Systematic comprehensive geriatric assessment.
  
  
  METHODS
  12-month rates of mortality, readmission, functional decline and need for new social help.
  
  
  RESULTS
  Among the 211 patients studied, 127 (60.2%) presented at least one MGS on admission: 86 frailty (40.8%), 67 cognitive impairment (31.8%), 31 severe dependency (14.7%) and 9 depression (4.3%). Patients with MGSs were slightly older (82±5 vs 81±4 years, p=0.02) but did not show greater disease severity or comorbidity. The presence of MGSs was associated with a higher incidence of functional decline during hospitalisation (35.7% vs 8.6%, p=0.002) and higher 12-month age-, comorbidity- and diagnosis-adjusted risks of readmission (OR, 2.1.92; 95% CI 0.98 to 3.7), functional decline (OR, 2.86; 95% CI 1.41 to 5.79) and need for new social help (OR, 3.10; 95% CI 1.45 to 6.60). MGSs were also associated with a higher 12-month mortality rate, which was only obvious in patients hospitalised for heart failure but not for other reasons.
  
  
  CONCLUSIONS
  A majority of older patients hospitalised for acute cardiac conditions in a cardiology department show at least one MGS on admission. MGSs are associated with poorer inhospital and postdischarge functional and clinical outcomes, particularly in patients with heart failure.
authors.affiliation: Department of Geriatric Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Elísabet
authors.initials: E
authors.lastname: Sánchez
authors.forename: María T
authors.initials: MT
authors.lastname: Vidán
authors.forename: José A
authors.initials: JA
authors.lastname: Serra
authors.forename: Francisco
authors.initials: F
authors.lastname: Fernández-Avilés
authors.forename: Héctor
authors.initials: H
authors.lastname: Bueno
mesh_terms: D000203:Activities of Daily Living; D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006331:Heart Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D006785:Hospitals, University; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D010359:Patient Readmission; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D020127:Recovery of Function; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology; D013997:Time Factors