title: Comprehensive geriatric assessment and hospital mortality among older adults with decompensated heart failure.
abstract: BACKGROUND
  The aim of this study is to assess whether a simple comprehensive geriatric assessment (CGA) score predicts hospital mortality among very elderly patients admitted with heart failure (HF).
  
  
  METHODS
  This is a prospective follow-up of 581 individuals aged ≥75 years admitted for decompensated HF to an acute geriatric unit from October 2006 to September 2009. A CGA score (range, 0-10) was constructed using baseline individual data on 5 domains: dependence in activities of daily living (Katz index), mobility (qualitative mobility scale), cognition (Mini-Mental State Examination), comorbidity (Charlson index), and number of prescribed medications.
  
  
  RESULTS
  Mean age of patients was 85.8 ± 5.8 years, 67% were women, and 75% had preserved ventricular function (ejection fraction >45%). Fifty percent of patients required assistance in ≥1 activities of daily living, 66% had mobility problems, 45% had cognitive impairment, the mean Charlson index was 3.97 ± 3.01, and 36% had >7 medications prescribed. As a result, the mean CGA score was 4.8 ± 2.2. Hospital mortality was 8.2%. In multivariate analysis, variables associated with hospital mortality included New York Heart Association functional class III (odds ratio [OR] 4.1, 95% CI 1.5-10.8), class IV (OR 19.6, 95% CI 6.3-61), pulmonary edema on chest radiography (OR 3.0, 95% CI 1.3-6.6), renal failure (OR 2.8, 95% 1.2-6.2), and the CGA score (OR 1.2, 95% CI 1.02-1.4 for each point of increment). The area under the receiver operating characteristic curve was 0.856 (95% CI 0.790-0.921), and the model classified 93.4% of cases correctly.
  
  
  CONCLUSIONS
  In our cohort of very old patients with HF, a simple CGA score predicts hospital mortality.
authors.affiliation: Department of Geriatric Medicine, Hospital Meixoeiro, Complejo Hospitalario Universitario de Vigo, Vigo, Spain. carlos.rodriguez.pascual@sergas.es
authors.forename: Carlos
authors.initials: C
authors.lastname: Rodríguez-Pascual
authors.forename: Arturo
authors.initials: A
authors.lastname: Vilches-Moraga
authors.forename: Emilio
authors.initials: E
authors.lastname: Paredes-Galán
authors.forename: Ana Isabel
authors.initials: AI
authors.lastname: Ferrero-Marinez
authors.forename: Marta
authors.initials: M
authors.lastname: Torrente-Carballido
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodríguez-Artalejo
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis; D015897:Comorbidity; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods; D006333:Heart Failure / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D009068:Movement; D011237:Predictive Value of Tests; D011446:Prospective Studies