title: Comprehensive geriatric assessment and 2-year mortality in elderly patients hospitalized for heart failure.
abstract: BACKGROUND
  In older adults hospitalized for heart failure, a poor score on a comprehensive geriatric assessment (CGA) is associated with worse prognosis during hospitalization and at 1 month after discharge. However, the association between the CGA score and long-term mortality is uncertain.
  
  
  RESULTS
  This is a prospective study of 487 patients aged ≥75 years admitted for decompensated heart failure. At discharge, a CGA score (range, 0-10) was calculated based on limitation in activities of daily living, mobility limitation, comorbidity, cognitive decline, and previous medication use. The analysis of the association between the CGA score and 2-year subsequent mortality was performed with Cox regression and adjusted for the main confounders. A 1-point increase in the CGA score was associated with a 19% higher mortality (hazard ratio, 1.19; 95% confidence interval, 1.11-1.27). Results were similar regardless of age, sex, left ventricular ejection fraction, and the coexistence of atrial fibrillation, ischemic heart disease, or hypertensive cardiopathy. All components of the CGA score showed a consistent association with higher death risk: the hazard ratio (95% confidence interval) of mortality was 1.78 (1.25-2.54) with ≥3 versus 0 limitations in activities of daily living, 1.36 (1.0-1.86) with moderate or severe versus no or mild limitation in mobility, 1.98 (1.29-3.03) with a ≥5 versus ≤1 score on the Charlson index, 2.48 (1.84-3.34) with previous cognitive decline, and 1.77 (0.99-3.18) in those using ≥8 versus ≤3 medications.
  
  
  CONCLUSIONS
  The score on a simple CGA is associated with long-term mortality in older patients hospitalized for heart failure.
authors.affiliation: Departments of Geriatric Medicine.
authors.forename: Carlos
authors.initials: C
authors.lastname: Rodriguez-Pascual
authors.forename: Emilio
authors.initials: E
authors.lastname: Paredes-Galan
authors.forename: Arturo
authors.initials: A
authors.lastname: Vilches-Moraga
authors.forename: Ana Isabel
authors.initials: AI
authors.lastname: Ferrero-Martinez
authors.forename: Marta
authors.initials: M
authors.lastname: Torrente-Carballido
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodriguez-Artalejo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003191:Comprehensive Health Care; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D006333:Heart Failure / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D013030:Spain; D016019:Survival Analysis
keywords: frail elderly; geriatric assessment; heart failure; mortality